肠外营养对慢性阻塞性肺疾病急性加重期治疗的影响

Effect of parenteral nutrition on the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨肠外营养(PN)支持对慢性阻塞性肺疾病急性加重期(AECOPD)患者治疗的影响。方法 AECOPD患者80例,随机均分为PN组及对照组,给予为期2周包括PN的综合治疗。结果 PN组有效率90%,高于对照组的65%(P<0.05)。对照组除血总淋巴细胞计数(TLC)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)显著改善外(P<0.05),其他参数均无显著变化。PN组除CD8及IgM、IgG变化不大,其他指标如实际体重与标准体重百分比(IBW%)、肱三头肌皮褶厚度(TSF)、上臂肌围(MAMC)、血清白蛋白(ALB)、TLC、CD3、CD4、CD4/CD8、IgA、用力肺活量(FVC)、1秒用力呼气容积占用肺活量比(FEV1/FVC)及PaO2、PaCO2均有明显改善(P<0.05)。结论包括PN的合理营养支持治疗可改善AECOPD患者的免疫功能和肺功能,提高临床疗效。

Objective To explore the effect of parenteral nutrition（PN） on the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.MethodsEighty patients with AECOPD were equally randomized into two groups of PN（with PN） and C（without PN）.The patients were given complex treatment inclouding PN support for two weeks.Results The effectiveness rate was higher in group PN than that in group C（90% vs.65%）（P0.05）.Except that the blood TLC,PaO2 and PaCO2 were improved（P0.05）,the other measurements were not changed significantly in group C.Except for CD8,IgM and IgG,IBW%,TSF,MAMC,ALB,TLC,CD3,CD4,CD4/CD8,IgA,FVC,FEV1/FVC,PaO2 and,PaCO2 were improved obviously in group PN（P0.05）.Conclusion The reasonable complex treatment including PN support can improve the immune and pulmonary functions and enhance the clinical outcomes in patients with AECOPD.