CAJ | 학술논문

目的：探讨精氨酸对重症脑卒中患者急性期营养状况及卒中后神经功能康复的影响。方法：采用前瞻性对照研究，将80例重症脑卒中患者按随机数字表法分为强化精氨酸肠内营养组(强化组)和普通肠内营养组(普通组)，于营养治疗前和营养治疗后的第10天、第20天分别检测白蛋白( ALB)、前白蛋白( PA)、三酰甘油( TG)、总胆固醇( TC)和淋巴细胞总数( TLC)。并对神经功能进行美国国立卫生研究院卒中量表( NIHSS)评分。结果：2组患者在营养治疗前，营养指标及NIHSS评分差异均无统计学意义(P>0.05)；治疗后第20天，强化组的血清ALB、PA和TLC均显著高于普通组(P<0.01)。强化组患者治疗后第10天和第20天PA及TLC均较治疗前有所下降，但差异均无统计学意义(P>0.05)；而普通组的ALB、PA水平和TLC均较治疗前下降(P<0.05~P<0.01)；治疗后第10天和第20天普通组和强化组患者的 NIHSS评分均较治疗前下降(P<0.01)，在营养治疗后第10天2组患者的NIHSS评分差异无统计学意义(P>0.05)，而在第20天强化组的评分比普通组更低(P<0.01)。结论：精氨酸能够明显改善重症脑卒中患者的营养状况，促进患者神经功能康复。
목적：탐토정안산대중증뇌졸중환자급성기영양상황급졸중후신경공능강복적영향。방법：채용전첨성대조연구，장80례중증뇌졸중환자안수궤수자표법분위강화정안산장내영양조(강화조)화보통장내영양조(보통조)，우영양치료전화영양치료후적제10천、제20천분별검측백단백( ALB)、전백단백( PA)、삼선감유( TG)、총담고순( TC)화림파세포총수( TLC)。병대신경공능진행미국국립위생연구원졸중량표( NIHSS)평분。결과：2조환자재영양치료전，영양지표급NIHSS평분차이균무통계학의의(P>0.05)；치료후제20천，강화조적혈청ALB、PA화TLC균현저고우보통조(P<0.01)。강화조환자치료후제10천화제20천PA급TLC균교치료전유소하강，단차이균무통계학의의(P>0.05)；이보통조적ALB、PA수평화TLC균교치료전하강(P<0.05~P<0.01)；치료후제10천화제20천보통조화강화조환자적 NIHSS평분균교치료전하강(P<0.01)，재영양치료후제10천2조환자적NIHSS평분차이무통계학의의(P>0.05)，이재제20천강화조적평분비보통조경저(P<0.01)。결론：정안산능구명현개선중증뇌졸중환자적영양상황，촉진환자신경공능강복。
Objective:To explore the effects of arginine on the nutritional status at acute episode and neurological rehabilitation of patients with severe stroke. Methods:Eighty patients with severe stroke were randomly divided into enriched arginine enteral nutrition group( intensive group) and normal enteral nutrition group( normal group) by the prospective controlled method. The levels of albumin (ALB),prealbumin(PA),triglycerides(TG) and total cholesterol(TC),total lymphocyte count(TLC) and NIH stroke scale(NIHSS) scores of nerve function in two groups were investigated before nutritional therapy and at 10 and 20 d after treatment. Results:The differences of nutritional indexes and NIHSS scores in two group before nutritional therapy were not statistical significance(P>0. 05), the levels of ALB,PA and TLC in intensive group were significantly higher than those in normal group at 20 d after treatment ( P<0. 01). Compared with before treatment,the level of PA and TLC in intensive group decreased,the difference of which had no statistical significance(P >0. 05). Compared with before treatment,the levels of ALB and PA and TLC in normal group were significantly decreased at 10 and 20 d after treatment(P<0. 05 to P<0. 01). Compared with before treatment,the NIHSS scores in two groups were decreased at 10 and 20 d after treatment(P<0. 01). The difference of NIHSS scores in two groups had no statistical significance at 10 d after treatment(P>0. 05),the NIHSS scores in intensive group was lower than that in normal group at 20 d after treatment(P<0. 01). Conclusions:Arginine can evidently improve the nutritional status and promote the recovery of neurological function in patients with severe stroke.