营养支持对危重病人免疫功能的影响

目的：探讨肠外加肠内营养支持与全肠外营养支持对危重病人免疫功能的影响。方法：将40例危重病人按就诊顺序分为2组，每组20例．试验组接受肠外＋肠内营养（PN＋EN）,对照组接受全肠外营养（TPN），2组等氮等热量供给。于治疗前后检测血浆总蛋白、白蛋白、血红蛋白和转铁蛋白浓度，外周血IgA、IgG、IgM、淋巴细胞总数（TLC）及T细胞亚群CD2、CD4百分率和CD4／CD8比值。结果：试验组TLC和IgG营养支持前后及与对照组相比其差异均有统计学意义（P〈0．05）；CD4和CD4／CD8比值也有升高，其差异有统计学意义（P〈0．05）；其余指标差异无统计学意义（P〉0．05）。结论：PN＋EN较TPN更能改善危重病人机体的免疫功能。促进患者康复，为危重病患者提供较好的营养支持方案。

The effect of parenteral nutrition in critically patients: a clinical controlled trail

Objective: To study the clinical effect of parenteral nutrition and enteral nutrition (PN+EN) on improve ment of immune function in critically patients compared with total parenteral nutrition (TPN). Methods: Forty critically patients were divided into 2 groups. In each group 20 patients were included. Twenty patients were treated with PN+EN in experimental group; 20 patients were treated with standard TPN in control group. Two groups were supplied with equal nitrogen and caloricity. Plasma levels of total protein, albumin, hemoglobin, peripheral plasma IgA, IgG, IgM concentrations and total lymphocyte counts (TLC), the percentage of T lymphocyte subsets (CD_3, CD_4), the ration of CD_4 and CD_8 were detected before and after treatment. Reasults: Evident increasing of TLC and IgG were found in experimental group compared with control group. The change were more significant statistically in the patients than those in the control (P<0.05). Percentage of CD_4 and the ratio of CD_4/CD_8 also increase evidently (P<0.05). The changes other items were insignificant statistically (P>0.05). Conclusion: PN+EN nutritional support can improve the immune function of surgical critically patients on current research condition. This study provide reasonable nutritional pattern for critically patients.