免疫肠内营养支持对急性脑梗死诱发SIRS的调理作用

Modulation of enteral immuno-nutrition supplement on patients with acute cerebral infarction plus Systemic inflammatory response syndrome

目的观察免疫肠内营养(EN)支持对急性脑梗死诱发全身炎症反应综合征(SIRS)患者细胞免疫功能和急性炎症反应的调理作用。方法选择急性脑梗死诱发SIRS病例64例,随机分为免疫EN治疗组和标准EN对照组各32例。在明确诊断后开始鼻饲,研究时间共10d。观察两组患者EN前后血清蛋白、免疫指标的变化及急性生理和慢性健康状况(APACHEⅢ)评分。结果研究结束时,治疗组的前白蛋白和转铁蛋白显著高于对照组(P<0.05),淋巴细胞总数、CD3、CD4、CD4/CD8及自然杀伤细胞活性显著高于对照组(P<0.05),白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及C-反应蛋白(CRP)显著低于对照组(P<0.01)。同时,治疗组的APACHEⅢ评分较对照组下降显著(P<0.05)。结论免疫EN支持可以改善急性脑梗死诱发SIRS患者的细胞免疫功能和急性炎症反应,有利于控制病情。

Objective To observe the adjustment of enteral immuno - nutrition supplement to patients, cells immune function and acute inflammation reaction who experience systemic inflammatory response syndrome（SIRS） after acute cerebral infarction. Metbods Sixty - four patients who experienced SIRS after acute cerebral infarction were randomized into the research group （32 cases） who used enteral immuno -nutrition and the contrast group （32 cases） who used standard enteral nutrition. All patients began to use enteral nutrition by gastric tube after diagnosed definitely. Study time amounts to 10 days. The alteration of serum protein levels and immune indexes and acute phgsiology and chronic health evaluation （ APACHE Ⅲ ） grade were observed. Results At the end of study, the levels of prealbumin and transfein,amounts of CD3, CD4 cells and lymph cells,ratio of CD4/CD8 and activation of natural kill （NK） cell were significantly higher in the research group than that of contrast group （ P 〈 0.05 ）. The research group has lower levels of interleukin - 6 （ IL - 6）, tumer necrosis -α factor（ TNF -α） and C - reactive protein（CRE）（P 〈 0.01）. At the same time,the APACItE m grades declined notably （P 〈 0.05 ）. Conclusions Enteral immunonutrition supplement can improve cells immune function and lighten acute inflammation reaction of patients who experience SIRS after acute cerebral infarction. It helps to control patient＇s condition.