强化谷氨酰胺的肠内营养对严重颅脑损伤患者应激状态和免疫功能的影响

Effect of glutamine enhanced enteral nutrition on stress status and immune function of patients with severe craniocerebral injury

目的观察应用强化谷氨酰胺的肠内营养对严重颅脑损伤患者应激和免疫状态的影响。方法72例严重脑损伤患者随机分为实验组和常规组,每组36例,放置鼻-十二指肠管,均使用肠内营养支持泵均匀持续滴注的鼻饲方法,实验组使用肠内营养制剂强化谷氨酰胺,常规组使用肠内营养制剂加蛋白粉,两者氨热比值保持一致。2周后抽静脉血,观察两组患者实验前后的应激状态[C3、C4、C反应蛋白(CRP)]和免疫功能(CD4+、CD8+、CD4+/CD8+I、gAI、gGI、gM)的变化。结果实验结束时实验组C3、C4、CRP低于实验前,实验组C3、C4、CRP含量均低于常规组,差异有统计学意义。实验结束时实验组CD4+、CD4+/CD8+I、gAI、gG均高于实验前,差异有统计学意义,CD4+、CD4+/CD8+I、gAI、gG均高于常规组,差异有统计学意义,两组的CD8+数量的差异无统计学意义(P>0.05)。结论强化谷氨酰胺的肠内营养能有效地改善严重脑损伤患者的应激和免疫状态。

Objective To evaluate the influence of glutamine(Glu) enriched enteral nutrition(EN) on stress status and immune function under severe brain injuries.Methods 72 patients with severe brain injury were randomly divided into the experimental group and the control group.Glutamine enriched enteral nutrition(EN) was given to the experimental group and protein powder enriched enteral nutrition(EN) was given to the control group with equal calorie and equal nitrogen using continuous infusion pump uniform of the nas...