瑞先肠内营养支持对慢重症患者免疫功能、营养状态的影响

目的:探讨瑞先肠内营养支持对慢性危重症(CCI,简称慢重症)患者免疫功能、营养状态的影响。方法:采用随机编号法将本院2017年6月至2018年5月收治的85例CCI患者分为观察组(n=43)与对照组(n=42)。观察组接受瑞先肠内营养,对照组接受瑞素肠内营养。比较两组重症监护病房(ICU)入住时间、感染发生率、胃肠道并发症发生率及28d病死率,干预前、干预1周、2周对营养指标[血清总蛋白(TP)、白蛋白(ALB)、血红蛋白(Hb)、转铁蛋白(TF)]、免疫功能指标[免疫球蛋白M(IgM)、IgA、IgG以及CD3^+、CD4^+、CD8^+、CD4^+/CD8^+]T细胞及炎症指标[血清C反应蛋白(CRP)、白细胞计数(WBC)、IL-6、IL-8]测定。结果:观察组ICU入住时间显著短于对照组(P<0.05);观察组感染发生率、28d病死率与对照组比较差异无统计学意义(P>0.05);观察组反流发生率4.65%,显著低于对照组的23.81%(P<0.05);两组干预1周、2周血清ALB、Hb、TF、IgM、IgA、IgG、CD3^+、CD4^+、CD4^+/CD8^+均显著上升,CD8^+、血清CRP、WBC、IL-6、IL-8水平均显著下降,差异有统计学意义(P<0.05);观察组干预2周血清ALB、Hb、TF、IgM、IgA、IgG、CD3^+、CD4^+、CD4^+/CD8^+均显著高于对照组,CD8^+显著低于对照组(P<0.05);观察组干预1周、2周血清CRP、WBC、IL-6、IL-8水平均显著低于对照组(P<0.05)。结论:瑞先肠内营养支持能明显改善CCI患者免疫功能、营养状况,减轻炎症反应。

Effect of Ruixian enteral nutrition support on immune function and nutritional status in patients with chronic critical illness

Objective:To investigate the effect of Ruixian enteral nutrition support on immune function and nutritional status in patients with chronic critical illness(chronic critical illness,CCI).Methods:Eighty-five patients with CCI who were admitted to the hospital from June 2017 to May 2018 were randomly divided into the observation group(n=43)and the control group(n=42).The observation group was treated with Ruixian enteral nutrition,and the control group was treated with Fresubin enteral nutrition.The length of stay in intensive care unit(ICU),incidence of infection,incidence of gastrointestinal complications and 28 d mortality rate were compared between the two groups.The nutritional indicators[serum total protein(TP),albumin(ALB),hemoglobin(Hb),transferrin(TF)],immune function indicators[immunoglobulin M(IgM),IgA,IgG and CD3^+,CD4^+,CD8^+,CD4^+/CD8^+]T-cells and inflammatory markers[serum C-reactive protein(CRP),white blood cell count(WBC),IL-6,IL-8]were determined before intervention and after 1 week and 2 weeks of intervention.Results:The length of residing in ICU of the observation group was significantly shorter than that of the control group(P<0.05).There was no significant difference in the incidence of infection or 28d mortality between the two groups(P>0.05).The incidence of reflux in the observation group was significantly lower than that in the control group(4.65%vs 23.81%)(P<0.05).Serum ALB,Hb,TF,IgM,IgA,IgG,CD3^+,CD4^+and CD4^+/CD8^+T cells in both groups incerased significantly after 1 week and 2 weeks of intervention,while CD8^+,levels of serum CRP,WBC,IL-6 and IL-8 are decreased significantly(P<0.05).Serum ALB,Hb,TF,IgM,IgA,IgG,CD3^+,CD4^+T cell and CD4^+/CD8^+T cell in observation group were significantly higher than those in the control group,while CD8^+T cell was significantly lower than that in the control group after 2 weeks of intervention(P<0.05).The levels of serum CRP,WBC,IL-6 and IL-8 in the observation group were significantly lower than those in the control group after 1 week and 2 weeks of intervention(P<0.05).Conclusion:Ruixian enteral nutrition support can significantly improve the immune function and nutritional status and reduce the inflammatory response in patients with CCI.