营养干预对重度溃疡性结肠炎病人的治疗价值

Effects of nutritional intervention treatment on severe ulcerative colitis

目的:探讨营养干预对重度溃疡性结肠炎(UC)的治疗价值。方法:回顾性分析36例重度UC病人资料,其中20例病人进行了肠外营养(PN)或肠内营养(EN)治疗为观察组,其余16例为对照组。比较两组病人住院时间以及治疗前后的营养指标、血清内毒素、IL-4和外周血CD4+CD25+调节性T细胞(CD4+CD25+Treg)水平。结果:给予营养干预的观察组病人住院时间较对照组明显缩短(P<0.05);治疗后的血清总蛋白(TP)、清蛋白(ALB)、前清蛋白(PA)、转铁蛋白(TF)水平较治疗前有明显增高,且改善程度显著高于对照组(P<0.05);治疗后的血清内毒素水平亦较治疗前明显降低;IL-4及外周血CD4+CD25+Treg水平明显增加,与对照组比,差异有统计学意义(P<0.05)。在营养支持中腹泻的发生率为20%,占所有不良反应的66.7%。结论:营养支持治疗可显著改善重度UC病人的临床病情及营养状况,对UC病人的免疫调节功能也有一定影响。

Objective： To explore the therapeutic effects of nutritional intervention on treating severe ulcerative colitis（ UC）. Methods： Clinical data of total 36 patients with severe UC were retrospectively analyzed. Among them,20 cases were subjected to the treatment of parenteral nutrition（ PN） /enteral nutrition（ EN）. The hospitalization time and the level of nutrition index,serum endotoxin,IL-4,the peripheral blood CD4^＋CD25^＋Treg frequencies before and after treatment were compared in the PN /EN group and non-PN / EN group. Results： After PN / EN support,the concentration of serum total protein and albumin,prealbumin,transferrin were significantly increased and the hospitalization time were shorten（ P〈0. 05）. PN / EN treatment also significantly decreased the level of the serum endotoxin and increased the level of IL-4 and the peripheral blood CD4^＋CD25^＋Treg（ P〈0. 05）. The diarrhea was most common in the adverse effect. Conclusion： PN / EN is an effective and safe nutrition support therapy,which could significantly improve the clinical condition and the nutritional status of UC patients.Furthermore,it has some effect on the immunoregulatory function of the UC patients.