生态免疫肠内营养在慢性阻塞性肺疾病急性加重患者中的应用

目的 探讨生态免疫肠内营养对慢性阻塞性肺疾病（COPD）急性加重期患者营养、免疫功能、生活质量的影响.方法 采取随机对照试验方法,将58例COPD急性加重期患者分为生态免疫肠内营养组（EIEN组）（n=29）和对照组（n=29）,疗程2周.比较两组患者治疗前后COPD评估测试（CAT）评分、体质量指数（BMI）、肱三头肌皮褶厚度（TSF）、上臂肌围（MAMC）、血清白蛋白（ALB）、前白蛋白（PA）浓度及免疫球蛋白、细胞亚群等指标的变化.结果 治疗2周后,两组患者CAT评分均较治疗前显著降低（P ＜0.001）.EIEN组治疗后CAT评分显著低于对照组（17.2±5.3 vs 24.6±4.8,P＜0.001）.治疗后EIEN组MAMC较治疗前升高（P＜0.05）,但与对照组治疗后比较无显著差异.治疗后EIEN组血清ALB、PA较治疗前均有显著升高（P＜0.001）;对照组患者血清PA较治疗前亦有升高（P＜0.05）.两组比较,治疗后EIEN组血清ALB、PA均显著高于对照组（P＜0.05）.治疗后EIEN组血清IgG、IgM、CD3、CD4/CD8较治疗前显著升高,CD8较治疗前降低,对照组患者IgM较治疗前亦有升高.两组治疗后比较,EIEN组血清IgG、IgM、CD3、CD4/CD8显著高于对照组,而CD8则显著低于对照组.结论 生态免疫肠内营养可显著改善COPD急性加重期患者的营养状况、免疫功能及生活质量,疗效优于普通肠内营养制剂,值得进一步研究并在临床推广应用.

Research of Ecoimmuno-enteral Nutrition Support in Chronic Obstructive Pulmonary Disease Patients with Acute Exacerbation

Objective To study the effect of ecoimmuno-enteral nutrition （EIEN） in chronic obstructive pulmonary disease （COPD） patients with acute exacerbation （AE）.Methods Fifty-eight patients with AECOPD were randomly divided into two groups：EIEN group （n =29） and control group （n =29）.COPD assessment test （CAT）,body mass index （BMI）,skinfold thickness of triceps （TSF）,mean arm muscle circumference （MAMC）,albumin （ALB）,prealbumin （PA）,immunoglobulin and T-cell subpopulations were detected and compared before and after treatment of 2 weeks.Results After 2 weeks＇ treatment,CAT score in both groups decreased significantly （P ＜ 0.001）.CAT score of EIEN group was significantly lower than that of control group after therapy （17.2 ± 5.3 vs 24.6 ± 4.8,P ＜ 0.001）.Though MAMC of EIEN group increased significantly after therapy （P ＜ 0.05）,no significant difference appeared between EIEN group and control group after therapy.After 2 weeks＇ treatment,ALB and PA of EIEN group increased significantly （P ＜0.001）,PA of control group also increased （P ＜ 0.05）.ALB and PA of EIEN group were significantly higher than those of control group after therapy （P ＜ 0.05）.Two weeks later,secrum IgG,IgM,CD3,CD4/CD8 of EIEN group were significantly higher than those of control group;secrum CD8 of EIEN group was significantly lower than that of control group.Conclusion For patients with AECOPD,ecoimmuno -enteral nutrition is helpful to improve nutritional status,immune function and life quality.Therefore,it is worth to apply in clinical.