早期肠内营养对重症急性胰腺炎患者血清CRP及T淋巴细胞亚群的影响

Effect of early enteral nutrition for severe acute pancreatitis patiens on serum C-reactive protein and T lymphocyte subsets

目的研究早期肠内营养(EEN)对重症急性胰腺炎(SAP)患者血清C反应蛋白(CRP)及T淋巴细胞亚群的影响。方法将45例SAP患者随机分为实验组(22例)和对照组(23例)。实验组给予EEN,对照组给予肠外营养(PN),待患者排气排便后给予EN(通常于入院后5～7 d)。于入院后第1、5、7、11天,检测两组患者血清CRP及T淋巴细胞亚群(CD3、CD4+、CD4+/CD8+值)。结果除3例排除实验,余42例SAP患者治愈。平均住院日及住院费用,实验组低于对照组(P<0.05)。两组间比较,血清CRP、T淋巴细胞亚群,在第1天的差异无统计学意义(P>0.05);第5、7、11天血清CRP水平,实验组低于对照组(P<0.05),T淋巴细胞亚群(CD3、CD4+、CD4+/CD8+值)水平实验组高于对照组(P<0.05)。结论给予EEN能更好地降低SAP患者急性反应期炎症反应,提高免疫功能。

Objective To study the effect of early enteral nutrition （EEN） for severe acute pancreatitis （SAP） patients on serum C-reactive protein （CRP） and T lymphocyte subsets. Methods Forty-five SAP patients were randomly divided into the experimental group （22 cases） and the control group （23 cases）. The experimental group was treated with EEN. The control group were treated with early parenteral nutrition （PN）, and EN was given after gastrointestinal function restored （usually after admission 5 to 7 d）. On the day 1, 5, 7 and 11 after admission, the patients of two groups were tested serum CRP and T lymphocyte subsets （CD3, CD4~, CD4~/CD8~ ratio）. Results Three patients were excluded experiment, and the other 42 cases were cured. The average hospitaliza- tion days and costs in experimental group were lower than that in control group （P〈0.05）. The serum levels of CRP and T lymphocyte subsets, on the first day, were not statistically significant differences between two groups （P〉0.05）. On the 5th, 7th and 11th hospitalization day, the serum CRP level was lower in experimental group than that in control group （P〈0.05）, and the T lymphocyte subsets （CD3, CD4~, CD4＋/CD8~ ratio） levels were higher in experimental group than those in control group （P〈0.05）. Conclusion This experiment shows that, by comparing experimental group with control group, the treatment for SAP patients with EEN is better in reducing inflammation on the acute reaction oeriod and better in improving immune function.