生态免疫肠内营养在慢性阻塞性肺疾病急性加重患者中的应用

Research of Ecoimmuno- enteral Nutrition Support in Chronic Obstructive Pulmonary Disease Patients with Acute Exacerbation

目的探讨生态免疫肠内营养对慢性阻塞性肺疾病(COPD)急性加重期患者营养、免疫功能、生活质量的影响。方法采取随机对照试验方法,将58例COPD急性加重期患者分为生态免疫肠内营养组(EIEN组)(n=29)和对照组(n=29),疗程2周。比较两组患者治疗前后COPD评估测试(CAT)评分、体质量指数(BMI)、肱三头肌皮褶厚度(TSF)、上臂肌围(MAMC)、血清白蛋白(ALB)、前白蛋白(PA)浓度及免疫球蛋白、细胞亚群等指标的变化。结果治疗2周后,两组患者CAT评分均较治疗前显著降低(P<0.001)。EIEN组治疗后CAT评分显著低于对照组(17.2±5.3 vs 24.6±4.8,P<0.001)。治疗后EIEN组MAMC较治疗前升高(P<0.05),但与对照组治疗后比较无显著差异。治疗后EIEN组血清ALB、PA较治疗前均有显著升高(P<0.001);对照组患者血清PA较治疗前亦有升高(P<0.05)。两组比较,治疗后EIEN组血清ALB、PA均显著高于对照组(P<0.05)。治疗后EIEN组血清IgG、IgM、CD3、CD4/CD8较治疗前显著升高,CD8较治疗前降低,对照组患者IgM较治疗前亦有升高。两组治疗后比较,EIEN组血清IgG、IgM、CD3、CD4/CD8显著高于对照组,而CD8则显著低于对照组。结论生态免疫肠内营养可显著改善COPD急性加重期患者的营养状况、免疫功能及生活质量,疗效优于普通肠内营养制剂,值得进一步研究并在临床推广应用。

Objective To study the effect of ecoimmuno-enteral nutrition （EIEN） in chronic obstructive pulmonary disease （COPD） patients with acute exacerbation （AE）.Methods Fifty-eight patients with AECOPD were randomly divided into two groups：EIEN group （n =29） and control group （n =29）.COPD assessment test （CAT）,body mass index （BMI）,skinfold thickness of triceps （TSF）,mean arm muscle circumference （MAMC）,albumin （ALB）,prealbumin （PA）,immunoglobulin and T-cell subpopulations were detected and compared before and after treatment of 2 weeks.Results After 2 weeks＇ treatment,CAT score in both groups decreased significantly （P ＜ 0.001）.CAT score of EIEN group was significantly lower than that of control group after therapy （17.2 ± 5.3 vs 24.6 ± 4.8,P ＜ 0.001）.Though MAMC of EIEN group increased significantly after therapy （P ＜ 0.05）,no significant difference appeared between EIEN group and control group after therapy.After 2 weeks＇ treatment,ALB and PA of EIEN group increased significantly （P ＜0.001）,PA of control group also increased （P ＜ 0.05）.ALB and PA of EIEN group were significantly higher than those of control group after therapy （P ＜ 0.05）.Two weeks later,secrum IgG,IgM,CD3,CD4/CD8 of EIEN group were significantly higher than those of control group;secrum CD8 of EIEN group was significantly lower than that of control group.Conclusion For patients with AECOPD,ecoimmuno -enteral nutrition is helpful to improve nutritional status,immune function and life quality.Therefore,it is worth to apply in clinical.