营养支持对重症肌无力患者呼吸功能的影响

Effection of nutritional support treatment for respiratory function in patients with Myasthenia Gravis

目的探讨营养支持在治疗重症肌无力患者中的应用价值。方法对78例MG患者常规治疗基础上给予肠内营养乳剂进行营养支持15d，记录患者肠内营养治疗前后营养指标（肱三头肌皮皱厚度、上臂肌困、白蛋白、肌酐、尿素氮、氮平衡）、呼吸功能指标（最大吸气压、最大呼气压、残气量、最大通气量、呼吸肌耐力）及临床肌无力严重度的变化情况。将治疗前后的上述指标进行分析比较。结果MG患者肠内营养支持治疗15d后，患者各项营养指标中，血浆白蛋白、肌酐水平和氮平衡均较营养支持前明显升高（P〈0．01），血尿素氮（BUN）水平较营养支持前明显下降（P〈0．01）；I型MG患者的肺功能状况已经较健康对照有所下降；经常规治疗和营养支持后，各型MG患者的肺功能状况以及临床肌无力严重度均有所改善。结论对MG患者，合理的肠内营养支持治疗可以改善机体的营养状态，改善患者肺功能及临床症状。

Objective To explore the clinical value of nutritional support treatment in patients with myasthenia gravis （MG）. Methods 78 MG patients were received ordinary treatment, as well as the intestinal nutritional treatment for 15 days. The data of the nutritional eonditions （including triceps skin fold thickness, upper arm muscle eircumferenee, the concentrations of plasma albumin, the levels of blood urea nitrogen and creatinine, the nitrogen balance）, the data of the respiratory function （the maxi- mal inspiratory pressure, the maximal expiratory pressure, the residual volume, the maximal ventilatory volume, the respiratory muscle endurance） and the score of clinical myasthenia severity were analized and compared before and after treatment. Results （1）The levels of plasma albumin and reatinine, the nitro- gen balance significantly increased 15 days later （all P 〈 0. 01）, while blood urea nitrogen significantly deereased （P 〈 0.01）. （2）Compared with the normal, the lung function status in patients with type I MG decreased. （3）Ordinary treatment combined with the intestinal nutrition effectively improve the lung function, respiratory muscle strength and the score of clinical myasthenia severity in patients with all types of MG. Conclusions For patients with MG, reasonable intestinal nutrition can improve nutritional status, effectively enhance the lung function and ameliorate clinical symptoms.