早期肠内营养联合合生元制剂对高血压脑出血患者细胞免疫功能的影响

目的 观察早期肠内营养联合合生元制剂对高血压脑出血患者细胞免疫功能和感染性并发症的影响. 方法 将53例高血压脑出血患者按照随机数字表法分为早期肠内营养组(对照组,26例)和早期肠内营养联合合生元制剂组(研究组,27例),对照组于伤后24～48 h采用肠内营养制剂(瑞素)开始营养支持;研究组则在对照组的基础上联合应用合生元制剂(金双歧,2 g,3次/d)14 d.2组患者在肠内营养营养支持0d、4d、8d和15 d分别检测外周血T淋巴细胞CD3+,T淋巴细胞亚群CD4+、CD8+和CD4+/CD8+,同时观察2组患者发生感染性并发症的差异. 结果研究组患者在营养支持的第8天,CD3+、CD4+、CD4+/CD8+的表达明显比对照组高,差异均有统计学意义(P＜0.05).在营养支持第15天,研究组CD3+、CD4+的表达仍比对照组明显升高,差异均有统计学意义(P＜0.05).研究组术后的感染性并发症的发生率低于对照组33.33%(9/27)vs46.15%(12/26)],但差异无统计学意义(P＞0.05). 结论 与普通早期肠内营养相比,添加合生元制剂的早期肠内营养有利于促进高血压脑出血患者细胞免疫功能恢复和降低感染性并发症的发生率.

Effect of early enteral nutrition combined with synbiotics agents on cellular immune function in patients with hypertensive intracerebral hemorrhage

Objective To investigate the effect of early enteral nutrition combined with synbiotics agents on cellular immune function and infectious complications in patients with hypertensive intracerebral hemorrhage. Methods Fifty-three patients with hypertensive intracerebral hemorrhage were randomly divided into early enteral nutrition treatment group (control group, n=26) and early enteral nutrition treatment combined with synbiotics agents group (experimental group, n=27). The patients in the control group received early enteral nutrition (RuiSu) within 24-48 h after injury. The patients in the experimental group received enteral nutritional support as the control group, but synbiotics (Golden Bifid,at a dosage of 2 g three times dairy) was also given in the first 14 d of enteral nutritional support. The peripheral blood T lymphocytes CD3+, T-lymphocyte subsets CD4+, CD8+ and CD4+/CD8+ were detectedon the 0, 4th, 8th, 15th d ofenteral nutrition support. The differences of the 2 groups in infectious complications was observed. Results On the 8th d of nutritional support, the expressions of peripheral blood CD3+, CD4+, CD4+/CD8+ were significantly higher in the experimental group than those in the control group (P＜0.05). On the 15th d of nutritional support, the expressions of peripheral blood CD3+ and CD4+ were still significantly higher in the experimental group than those in the control group (P＜0.05).The incidence of infectious complications in the experimental group was lower than that in the control group (33.33%, 9/27 vs. 46.15%, 12/26], P＞0.05). Conclusion Compared with ordinary enteral nutrition alone, enteral nutrition combined with synbiotics agents are more conducive to the recovery of cellular immune function and can reduce the incidence of infectious complications in patients with hypertensive intracerebral hemorrhage.