慢性阻塞性肺病急性加重期26例营养支持探讨

Discussion on Effection of Nutritional Support Therapy on 26 Patients with COPD

目的:讨论静脉营养支持疗法对患者营养状况和免疫功能的影响。方法:选择2010年11月-2012年3月在本院就诊的26例患者,随机分组为营养支持组和对照组,每组各13例,对照组给予常规治疗,营养支持组在对照组基础上还进行连续管饲3周能全力作为营养支持,并分别记录治疗前后两组患者的免疫指标和营养指标。结果:经能全力营养支持治疗后,患者的各项营养指标均有较大改善(P<0.05);营养支持组肱三头肌皮褶厚度(TSF)、上臂肌围长(MAMC)、血浆总蛋白(TP)、血清白蛋白(Alb)、前白蛋白(PAlb)、转铁蛋白(TRF)均较常规治疗组有明显改善(P<0.05);同时,在患者治疗前后的自身对照中,各项指标也均有明显升高(P<0.05);其免疫状况也有所好转,免疫球蛋白IgG、IgA和淋巴细胞CD3+、CD4+,以及CD4+/CD8+在治疗前后患者的自身对照和与常规组治疗的组间比较中,差异均有统计学意义(P<0.05)。结论:给予慢性阻塞性肺病急性加重期的患者营养支持治疗,可以有效提高临床疗效,提升患者生存质量,有利于改善患者预后,值得在临床广泛推广应用。

Objective： To explore the effect of nutritional support in treatment of patients with chonic obstructive pulmonary disease（COPD）. Method： 26 patients with COPD treated in the hospital were randomly divided into two groups： parenteral nutrition group and control group, and each group had 13 patients. Both the two group received routine treatment, and the parenteral group received nutritional therapy for 3 weeks. The nutrition and immune function were observed. Result： The indexes of nutritional support was significantly better than that of the control group（P0.05）. The indexed of TSF, MAMC, TP, Alb, PAlb, TRF were significantly increased than those of control group and self-control in pre-therapy（P0.05）. The indexes of IgG, IgA, CD3＋, CD4＋, and CD4＋/CD8＋ were significantly better than those of control group and self-control in pre-therapy（P0.05）. Conclusion： Nutritional support can improve immune and enhance clinical effect in patients during acute exacerbation of COPD.