早期免疫营养对重型颅脑损伤患者营养状况及免疫功能的影响

目的：探讨早期免疫营养对重型颅脑损伤患者营养状况及免疫功能的影响，为重型颅脑损伤患者营养支持治疗提供科学依据。方法采用随机数字法将60例重型颅脑损伤患者分为3组：对照组、早期营养组及早期免疫营养组各20例。对照组采用传统营养方法，早期营养组采用肠外营养（ PN ）和肠内营养（ EN ）序贯营养支持治疗，早期免疫营养组在早期营养的基础上每天给予谷氨酰胺10 g。分别检测患者第1天、第7天和第14天的总蛋白、白蛋白、转铁蛋白、免疫球蛋白、CD3＋、CD4＋及CD8＋水平，进而对其检测结果进行相互对比分析。结果总蛋白、白蛋白、CD4＋、CD8＋、CD4＋/CD8＋、IgG 水平比较，早期免疫营养组＞早期营养组＞对照组（P＜0．05），且随治疗时间的延长升高越明显（P＜0．05）。结论早期的免疫营养对改善重型颅脑损伤患者营养状况及促进免疫功能的恢复具有重要的作用。

Effect of Early Enteral Nutrition on Nutritional Status and Immune Function in Patients with Severe Head Injury

Objective To investigate the effect of early enteral nutrition on nutritional status and immune function in patients with severe head injury ,and to provide a scientific basis for nutritional support treatment in patients with severe head injury .Methods Using the method of random number ,60 patients with severe head injury were randomly divided into 3 groups,control group,early nutrition group and early immune nutrition group ,with 20 patients in each group. The control group was given the traditional nutrition , the early nutrition group was given sequential nutrition support treatment of parenteral nutrition （ PN） and enteral nutrition （ EN） ,the early immune nutrition group was given glutamine （10 g daily） based on the early nutrition.The patients were detected for total protein ,albumin,transferrin,immunoglobulin, CD3＋,CD4＋and CD8＋levels on the first ,seventh and fourteenth day ,then the results were analyzed .Results The levels of total protein,albumin,CD4＋,CD8＋,CD4＋/CD8＋,IgG of early immune nutrition group were higher than those of early nutrition group which were higher than the controls （P〈0.05）,and the increase was more significant with the increasing treatment time（P〈0.05）.Conclusion Early immune nutrition plays an important role in improving the recovery of nutrition status and immune function in patients with severe head injury .