危重症病人营养支持对免疫功能影响的临床研究

The effect of nutritional support on immune function in critically ill patients

目的:探讨肠外+肠内营养(PN+EN)与全肠外营养(TPN)支持,对危重症病人免疫功能的影响。方法:将40例危重症病人按就诊顺序分为两组,每组20例。试验组接受PN+EN,对照组接受TPN,两组等氮、等热量供给。于治疗前、后检测血浆总蛋白、清蛋白、血红蛋白和转铁蛋白浓度,外周血IgA、IgG、IgM、淋巴细胞总数(TLC)及T细胞亚群CD3、CD4百分率和CD4/CD8比值。结果:试验组TLC和IgG与对照组相比,差异有显著性意义(P<0.05);CD4和CD4/CD8比值也有升高(P<0.05);其余指标无明显差异(P>0.05)。结论:PN+EN较TPN更能改善危重症病人的免疫功能。

Objective ： To study the effect of parenteral and enteral nutrition （ PN ＋ EN） on immune function in critically ill patients. Methods： 40 critically ill patients were divided into 2 groups. In each group 20 patients were included. 20 patients were treated with PN ＋ EN in experimental group and 20 patients were treated with standard TPN in control group. Two groups were supplied with equal nitrogen and calorie. Plasma levels of total protein, albumin, hemoglobin, IgA, IgG and IgM and total lymphocyte counts （ TLC）, the percentage of T lymphcyete subsets （ CD3, CD4） and the ratio of CD4 and CD8 were detected before and after treatment. Results： TLC and IgG were significantly increased in experimental group compared with control group. Percentage of CD4 and the ratio of CD4/CD8 were also increased（P 〈 0.05 ）. The changes of other items were not significant. Conclusion ： PN ＋ EN can improve the immune function of critically ill patients.