摘要
目的探究肠内营养(EN)对肝硬化患者肝功能、血清蛋白水平、血清炎症因子变化及临床疗效的影响。方法选取笔者所在医院172例肝硬化患者为研究对象,采用随机数字表法分为对照组及观察组,各86例。两组均给予保肝、退黄、降酶、利尿(合并腹水者)等基础治疗,对照组在此基础上予以常规营养干预,观察组则予以EN干预。比较两组干预前及干预2个月后肝功能指标[总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)]、血清蛋白[血清总蛋白(TP)、清蛋白(ALB)、转铁蛋白(TF)]水平、血清炎症因子[白细胞介素-21(IL-21)、白细胞介素-10(IL-10)]水平及血清胰岛素样生长因子-1(IGF-1)水平差异,并记录干预4周后两组肝功能分级(Child-Pugh分级)差异。结果干预2个月后,两组肝功能指标(TBIL、ALT、AST)、部分血清炎症因子(IL-21)水平均较干预前降低(P<0.05),血清蛋白(TP、ALB、TF)水平、部分血清炎症因子(IL-10)水平及血清IGF-1水平则较干预前升高(P<0.05),且观察组变化幅度均大于对照组(P<0.05)。干预2个月后,观察组Child-Pugh分级严重程度低于对照组(P<0.05)。结论 EN对肝硬化患者肝功能损伤具有保护作用,且有改善营养状态作用,还能缓解患者炎性反应,于患者病情转归有利。
Objective To explore the influence of enteral nutrition(EN) on their liver function,serum protein level,serum inflammatory factors and clinical efficacy in patients with liver cirrhosis. Methods The 172 cases with liver cirrhosis in author's hospital were selected in the study and were divided into control group and observation group (with 86 cases in each group) according to the random number table method. The two groups were given basic treatments of liver protection,removing jaundice,descending enzyme and inducing diuresis (with ascites),and control group was also given routine nutritional intervention,and observation group was also given EN intervention. The liver function indexes[total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST)],serum protein[serum tota protein(TP),albumin(ALB),transferrin(TF)],serum inflammatory factors [interleukin-21(IL-21),interleukin-10(IL-10)] and serum insulin-like growth factor-1 (IGF-1) were compared between the two groups before intervention and 2 months after intervention,and the liver function grade (Child-Pugh grade) was recorded in the two groups 4 weeks after intervention. Results Two months after intervention,the levels of liver function indexes (TBIL,ALT,AST) and partial serum inflammatory factors (IL-21) in the two groups were lower than those before intervention (P<0.05) while the levels of serum protein (TP,ALB, TF),partial serum inflammatory factors (IL-10) and serum IGF-1 were higher than those before intervention (P<0.05),and the changes in observation group were greater than those in control group (P<0.05). Two months after intervention,the severity of Child-Pugh grade was lower in observation group was lower than that in control group (P<0.05). Conclusion EN has a protective effect on liver function damage in patients with liver cirrhosis,and has a good role in improving the nutritional status,and it also can alleviate the inflammatory response,thus favorable to outcome of patients.
作者
郭艳
GUO Yan(Digestive Medicine Dept.,Xinxiang City's Central Hospital,Xinxiang,Henan 453000,China)
出处
《实用医药杂志》
2019年第2期109-112,共4页
Practical Journal of Medicine & Pharmacy
关键词
肝硬化
肠内营养
肝功能
炎症因子
临床疗效
Liver cirrhosis
Enteral nutrition
Liver function
Inflammatory factors
Clinical effect