早期肠内营养对重症急性胰腺炎患者炎症细胞因子水平及免疫功能的影响

Effects of early enteral nutrition in patients with severe acute inflammatory cytokine levels and immune function

目的:探讨早期肠内营养对重症急性胰腺炎患者炎症细胞因子水平及免疫功能影响。方法:将92例患者随机分为观察组(n=46)和对照组(n=46)。对照组采用肠外营养,观察组给予早期肠内营养。观察两组C-反应蛋白(CRP)、白细胞计数(WBC)、尿淀粉酶、血淀粉酶恢复正常时间,炎症细胞因子水平、肝肾功能、免疫功能及血清CRP水平变化。结果:观察组CRP、WBC、尿淀粉酶、血淀粉酶恢复正常时间明显短于对照组,差异具有统计学意义(P<0.05);观察组治疗后白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)明显低于对照组,而白介素-10(IL-10)明显高于对照组,差异具有统计学意义(P<0.05);观察组治疗后谷草转氨酶(AST)、谷丙转氨酶(ALT)高于对照组,差异具有统计学意义(P<0.05);两组治疗后肌酐(Scr)水平较治疗前降低,而血尿素氮(BUN)较治疗前明显增加,差异具有统计学意义(P<0.05);观察组治疗后CD3、CD4+、CD4+/CD8+高于对照组,血清CRP明显低于对照组,差异具有统计学意义(P<0.05)。结论:早期肠内营养可明显降低重症急性胰腺炎炎症反应,提高机体免疫功能,具有重要临床研究意义。

Objective： To investigate effects of early enteral nutrition in severe acute levels of cytokines and immune function in patients with inflammatory cells panereatitis. Methods： According to the random number table, 92 patients were randomly divided into two groups （n = 46） and control group （n = 46）. Control group was treated with parenteral nutrition,while observation group was treated with enteral nutrition. CRP, WBC, urine amylase, serum amylase returned to normal time, inflammatory cytokines, liver and kidney function, immune function and serum CRP levels were detected and compared. Results; The CRP, WBC, urine amylase, serum amylase recovery time of the observation group was significantly shorter than that of the control group （P〈0.05）. After treatment, AST and ALT of the observation group was significantly higher thanthat of the control group （P〈0.05）. After treatment Scr level was decreased while BUN level was increased significantly than that before treatment （P〈0.05）. After treatment, CD3, CD4^＋ , CD4^＋/CD8^＋ of the observation group were higher than that of the control group （P〈0.05） ; but serum CRP was significantly lower than the control group （P〈0.05） . Conclusion： Early enteral nutrition for severe acute pancreatitis can significantly reduce inflammation, improve immune functione.