强化肠内营养对艾滋病患儿营养状况及免疫功能的影响

目的 观察谷氨酰胺（Gln）强化的肠内营养干预对艾滋病患儿营养状况和T淋巴细胞免疫功能的影响.方法 将符合纳入标准的60例艾滋病患儿用随机数字表随机纳入观察组（Gln强化组30例）与对照组（常规型肠内营养组30例）.干预前和干预第28天分别检测两组患儿营养相关指标、细胞免疫指标及血清Gln浓度变化.结果 干预第28天观察组患儿的外固血总淋巴细胞计数（TLC）（2.81 ±0.25）×109/L比（2.53±0.24）×109/L]、血清Gln水平（7.2±2.1） μmol/L比（5.5±1.2） μmol/L]较对照组升高明显（P＜0.05）；观察组血清白蛋白（ALB）（40.5±3.1）g/L比（38.6±2.1）g/L]、CD4＋百分比（39.0±7.5）％比（35.3±9.9）％]、CD;/CD;比值（1.6±0.8）比（1.2±0.6）]明显高于对照组（P＜0.01）；观察组胃肠道并发症的发生率也较对照组低（16.7％比40.0％,P＜0.01）.结论 强化肠内营养干预能改善艾滋病患儿营养状况,提高其T淋巴细胞免疫水平,降低胃肠道并发症发生率,值得临床应用推广.

The influence of the enhanced enteral nutrition on nutritional status and immune function in children with HIV/AIDS

Objective To investigate the effect of enhanced glutamine（Gln） enteral nutrition intervention on the nutrition status and T lymphocytes-mediated immune function in children with HIV/AIDS. Methods According to the inclusion criteria,60 children with AIDS were randomly divided into observation group （ Gin improved group 30 cases） and control group （conventional enteral nutrition group 30 cases）. Before intervention and 28 days after intervention, the nutrition related index,index of cellular immunity and serum Gln changes were detected in two groups. Results In the observation group 28 days after intervention, the TLC and serum level of Gln was （2.81 ± 0.25）× 109/L, （7.2±2.1 ） μmol/L,which were significantly higher than those in the control group （2.53±0.24）× I09/L, （5.5 ± 1.2） μmol/L （ P 〈 0.05 ）. In observation group, ALB was （40.5±3.1 ） g/L, the percentage of CD4^ was （39. 0 ± 7.5） %, CD4^＋CDS＋ratio was （ 1.6±0.8 ）, which were significantly higher than those in the control group （38.6 ±2.1 ）g/L, （35.3±9.9） %, （ 1.2±0.6） （P 〈0. 01 ）. Observation group had lower incidence rate of gastrointestinal complications （ 16. 7% vs 40.0%, P 〈 0. O1 ）. Conclusion Enhanced enteral nutrition intervention can improve nutritional status in children with HIV/AIDS, raise the level of T lymphocyte immunity, reduce the incidence of gastrointestinal complications, which was worthy of clinical promotion.