CAJ | 학술논문

目的比较肠内营养(EN)和肠外营养(PN)对全身炎性反应综合征(SIRS)患者炎性因子和免疫功能的影响.方法以2006年4月至2010年4月在山西医科大学第一医院、山西省人民医院和太原市中心医院收治的85例SIRS患者为研究对象,根据营养支持方式分为EN组(n=49)和PN组(n=36),比较两组患者营养支持前后炎性和免疫指标的变化情况.结果全热量营养支持后第7、14天,两组患者的体重、上臂周径、三头肌皮褶厚度及血清总蛋白和白蛋白水平均明显高于支持前(P均＜0.05);全热量营养支持后第14天,EN组患者的血清总蛋白和白蛋白水平明显高于PN组患者(P均＜0.05).全热量营养支持后第7、14天,EN组患者的血清肿瘤坏死因子α、白细胞介素(IL)-8、IL-l β水平均明显低于支持前和PN组患者(P均＜0.05);血CD4/CD8及IgG水平均明显高于支持前和PN组患者(P均＜0.05).结论 PN和EN均可有效改善SIRS患者的营养状态.EN在改善患者营养状况、提高免疫功能和降低炎性介质释放方面的效果优于PN.
목적 비교장내영양(EN)화장외영양(PN)대전신염성반응종합정(SIRS)환자염성인자화면역공능적영향.방법 이2006년4월지2010년4월재산서의과대학제일의원、산서성인민의원화태원시중심의원수치적85례SIRS환자위연구대상,근거영양지지방식분위EN조(n=49)화PN조(n=36),비교량조환자영양지지전후염성화면역지표적변화정황.결과 전열량영양지지후제7、14천,량조환자적체중、상비주경、삼두기피습후도급혈청총단백화백단백수평균명현고우지지전(P균＜0.05);전열량영양지지후제14천,EN조환자적혈청총단백화백단백수평명현고우PN조환자(P균＜0.05).전열량영양지지후제7、14천,EN조환자적혈청종류배사인자α、백세포개소(IL)-8、IL-l β수평균명현저우지지전화PN조환자(P균＜0.05);혈CD4/CD8급IgG수평균명현고우지지전화PN조환자(P균＜0.05).결론 PN화EN균가유효개선SIRS환자적영양상태.EN재개선환자영양상황、제고면역공능화강저염성개질석방방면적효과우우PN.
Objective To compare influences of enteral nutrition (EN) and parenteral nutrition (PN) on the inflammatory factors and immune functions in patients with systemic inflammatory response syndrome. Methods Totally 85 patients who were treated in the First Hospital of Shanxi Medical University, Shanxi Province People's Hospital, and Taiyuan Central Hospital from April, 2006 to April, 2010 were enrolled in this study and divided into EN group (n = 49) and PN group (n = 36) according to nutrition support modes. The changes of inflammatory factors and immune functions after nutritional supports were recorded and compared between these two groups. Results The weight, arm circumference, skin fold thickness of brachial triceps, total protein, and serum albumin were significantly improved on the 7th and 14th day after nutrition supports in both two groups compared with the baseline levels (all P ＜ 0.05). On the 14th day after nutritional support, the levels of total protein and serum albumin were significantly higher in EN group than in PN group. On the 7th and 14th day, the levels of tumor necrosis factor-α, Interleukin (IL)-8, and IL-1β in EN group were significantly lower than those in PN group and baseline levels (all P ＜ 0. 05). The blood CD4/CD8 and IgG in EN group were significantly increased compared with the baseline levels and those in PN group (both P ＜0. 05). Conclusions Both PN and EN can effectively improve the nutritional status of patients with SIRS. EN has superior effectiveness in EN group than in PN group in terms of improving nutritional status, ameliorating immune function, and reducing the release of inflammatory factors.