烧伤后早期应用中/长链甘油三酯对患者免疫功能的影响

目的　探讨烧伤后早期肠内喂养中链甘油三酯 (MCT) /长链甘油三酯 (LCT)对机体免疫功能的影响及其可能机制。　方法　选取 30例烧伤面积 >30 %TBSA的患者 ,随机分为两组 (每组 15例 )。F组 ,饲以含MCT/LCT的肠内营养制剂Fresubin 75 0MCT ;N组 ,饲以只含LCT的肠内营养制剂Nutrison。于伤后 2 4h内进行完全肠内营养支持 ,共持续 10d。于伤后 1、4、7、10d检测两组患者血浆白细胞介素 (IL) 2、IL 4、前列腺素 (PG)E2 及外周血T淋巴细胞转化率的改变。　结果　伤后各时相点F组患者血浆IL 2水平与N组相比 ,无明显差异 (P >0 .0 5 ) ;伤后 4dF组PGE2 水平较N组明显降低 (P <0 .0 1) ;伤后 4、7、10dF组IL 4水平及外周血T淋巴细胞转化率均明显高于N组 (P <0 .0 5～ 0 .0 1)。　结论　在改善烧伤后机体的免疫功能方面 ,含MCT/LCT的肠内营养制剂较单纯LCT制剂更具优势。

Effects of medium and long-chain triglyceride on the immune function of burn patients during early postburn stage

Objective To explore the effects of medium and long chain triglyceride on the immune function of burn patients during early postburn stage and its possible mechanism. Methods Thirty burn patients with TBSA execeeding 30% were enrolled in this study and were randomly divided into two groups ( n=15 in each group). The patients in F group were supplemented orally with enteral nutrient Fresubin 750MCT containing medium (MCT) and long chain triglyceride(LCT), and those in N group with Nutrison containing only LCT. All the patients were treated with nutritional support begining from 24 PBH,continued for 10 days. The changes in plasma levels of IL 2, IL 4, PGE 2 and T lymphocyte transformation rate (LTR) in peripheral blood of patients in the two groups were determined on 1,4,7 and 10 postburn days (PBDs). Results The plasma IL 2 level in all time points exhibited no difference in all patients (P> 0.05). The plasma level of PGE 2 on PBD 4 in F group was obviously lower than that in N group (P< 0.01). The plasma level of IL 4 on PBDs 4, 7 and 10 in F group were evidently higher than that in N group (P< 0.01). The T LTR in peripheral blood on PBDs 4 and 7 in F group was much higher than that in N group (P< 0.05-0.01). Conclusion Enteral nutrient containing MCT/LCT seemed to be superior to that containing only LCT in the improvement of postburn immune function in burn patients. [