早期免疫肠内营养对重症胰腺炎患者肠屏障、营养状态及免疫功能的影响

Influence of nutritional status and immune function of early immune enteral nutrition on severe acute pancreatitis patients with intestinal barrier

目的探究早期免疫肠内营养支持治疗对重症急性胰腺炎患者肠屏障、营养状态及免疫功能的影响状况。方法对2012年3月至2014年3月收治的64例重症急性胰腺炎患者,按照随机数字表分组法,分成观察组与对照组,均32例,观察组行早期免疫肠内营养治疗,对照组行普通肠内营养治疗,对比两组患者治疗前与治疗第10d的免疫指标及预后状况。结果两组患者治疗第10d的白细胞计数(WBC)、淀粉酶(AMS)、免疫球蛋白G(Ig G)、免疫球蛋白M(Ig M)、免疫球蛋白A(Ig A)、免疫细胞CD4、CD4/CD8细胞比值、急性生理学及慢性健康状况评分Ⅱ(APACHEⅡ)及CT评分等指标水平均显著低于治疗前,差异有统计学意义(均P<0.05);观察组患者治疗第10d的WBC、AMS、Ig G、Ig M、Ig A、CD4、CD4/CD8、APACHEⅡ、CT评分等指标水平及感染率与对照组患者相比,差异有统计学意义(均P<0.05)。结论早期采用免疫肠内营养支持治疗重症急性胰腺炎患者,可以有效维护肠屏障功能、增强免疫力,并调整患者的营养状态,具有较高的临床推广价值。

Objective To explore the influence of nutritional status and immune function of early immune enteral nutri- tion support treatment for severe acute pancreatitis patients with intestinal barrier. Methods In our hospital in March 2012 to March 2014 were treated 64 cases of severe acute pancreatitis patients, according to random number table group- ing, divided into observation group and control group, each 32 cases, observation group early immune enteral nutrition therapy,the control line ordinary enteral nutrition therapy ,compared two groups of patients before and 10 d treatment of immune index and the status of the prognosis. Results Two groups of patients to treat 10 d white blood cell count （ WBC ） , amylase （AMS） , immunoglobulin G （IgG） , immunoglobulin M （ IgM ） , immunoglobulin A （ IgA ） , immune cells CD4, CD4/CD8 ratio, acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ）and CT grading index levels were signifieantly lower than before the treatment, the difference was statistically significant （all P 〈 0. 05 ） ; Observation group of patients to treat 10 d the WBC, AMS, IgM and IgA, IgG, CD4, CD4/CD8, APACHE Ⅱ, CT grading index level and infection rate, compared with the control group patients was statistically significant difference （P 〈 0.05 ）. Conclusion Early immune enteral nutrition support treatment in severe acute panereatitis patients, can effectively maintain the intestinal barrier function, enhance immunity, and adjusting the nutritional status of pa- tients, has high clinical value.