肠内微生态营养对RICU中老年COPD呼吸衰竭患者营养及免疫功能的影响

目的:探讨肠内肠内微生态营养营养治疗对RICU重度慢性阻塞性肺疾病并呼吸衰竭患者营养状态、免疫功能、血气分析等的影响。方法:采取随机对照试验方法,将60例COPD急性加重期患者分为肠内微生态营养组(EIEN组)(n=30)和普通肠内营养对照组(n=30)疗程10~14天。比较两组患者治疗前后患者NRS2002-1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)浓度及感染指标PCT、免疫球蛋白、细胞亚群、血气分析等指标的变化。结果:治疗10~14天后,两组患者营养状况改善无显著差异(P>0.05),但治疗后两组患者营养状况较治疗前均有改善。营养组治疗后免疫功能改善高于对照组(P<0.05)。营养组治疗后血气分析改善高于对照组,营养组治疗的感染指标改善高于对照组。营养组腹泻及腹胀发生率低于对照组,平均住院天数及死亡率低于对照组(P值均<0.05)。结论:肠内微生态营养能明显改善慢性阻塞性肺疾病急性加重期合并呼吸衰竭患者的免疫功能和营养状况,同时能减轻全身炎性反应,促进疾病恢复。

Effect of Intestinal Microecological Nutrition on Nutrition and Immune Function in Old Agepatients With RICU Respiratory Failure

Objective: To investigate the effects of Intestinal microecological nutritiontherapy on nutritional status, immune function and blood gas analysis in patients with severe chronic obstructive pulmonary disease(RICU) complicated with respiratory failure. Methods: 60 patients with acute exacerbation of COPD were divided into two groups: EIEN group(n=30) and general enteral nutrition control group(n=30) for 14 days. The changes of NRS2002-1 score, body mass index(BMI), triceps skinfold thickness(TSF), upper arm muscle circumference(MAMC), serum albumin(ALB), prealbumin(PA) concentration, infection index PCT, immunoglobulin, cell subsets and blood gas analysis were compared between the two groups before and after treatment. Results: After 14 days of treatment, there was no significant difference in nutritional status between the two groups(P>0.05), but after treatment, the nutritional status of the two groups was improved. The improvement of immune function in ecological immune nutrition group was higher than that in control group after treatment(P<0.05). After treatment, the improvement of blood gas analysis in the ecological immune nutrition group was higher than that in the control group, and the infection index in the ecological immune nutrition group was higher than that in the control group. Conclusion: Intestinal microecological nutrition can significantly improve the immune function and nutritional status of patients with acute exacerbation of chronic obstructive pulmonary disease complicated with respiratory failure, at the same time, it can reduce the systemic inflammatory reaction and promote the recovery of the disease.