低剂量肠内营养对心肾综合征患者脏器功能保护及机制分析

Protection and Mechanism of Low Dose Enteral Nutrition on Organ Function in Patients with Cardiac and Renal Syndrome

目的:探讨低剂量肠内营养对Ⅰ型心肾综合征患者脏器功能保护以及机制分析。方法:选择2012年10月-2015年10月诊断为Ⅰ型心肾综合征患者109例,以信封法随机分为研究组(54例)与对照组(55例)。研究组患者发病后给予低剂量、低氮肠内营养,对照组患者给予充分剂量肠内营养治疗。分别于治疗前、治疗后第5天检测两组患者血白蛋白、前蛋白、谷草转氨酶、胱抑素C与肌钙蛋白I水平,采用酶联免疫吸附法检测的血清C反应蛋白与白介素-6水平,比较两组患者治疗期间呕吐发生率、胃潴留发生率、胰岛素抵抗水平、ICU住院时间、总住院费用。结果:治疗前,两组患者性别、年龄、心脏以及肝肾功能水平比较,差异均无统计学意义(P>0.05)。治疗后第5天,研究组与对照组患者血白蛋白、前蛋白水平较治疗前均上升,谷草转氨酶、胱抑素C与肌钙蛋白I与血清C反应蛋白与白介素-6水平均下降,但研究组改善幅度优于对照组,两组患者组内以及组间比较差异均有统计学意义(P<0.05);研究组与对照组比较,呕吐发生率、胃潴留发生率、胰岛素抵抗水平、平均血糖值、ICU住院时间、总住院费用均下降,两组比较差异均有统计学意义(P<0.05)。结论:Ⅰ型心肾综合征患者发病早期给予低剂量肠内营养有助于脏器功能保护以及营养水平改善,分析原因可能与低剂量肠内营养对于肠道功能保护、减轻机体炎性反应有关。

Objective： To investigate the protective effect and mechanism of low close enteral nutrition on organ function in patients with I type cardiac and renal syndrome.Method： From October 2012 to October 2015, 109 patients with I type cardiac and renal syndrome were selected and randomly divided into the study group （ 54 cases ） and the control group （ 55 cases ） .The study group was given low dose and low nitrogen enteral nutrition after onset, and the control group was treated with adequate doses of enteral nutrition.Before treatment, on the 5th day after treatment, the levels of serum albumin, prealbumin, aspartate aminotransferase, Cystatin C and troponin I were respectively detected.Used enzyme-linked immunosorbent assay for the detection of serum C-reactive protein and interleukin-6 levels.Compared with vomiting incidence, gastric retention rate, insulin resistance, ICU hospital stay, the total hospitalization costs of two groups patients during the treatment.Result： Before treatment, there were no significant differences in gender, age, heart and liver and renal function between two groups （ P〉O.05 ） .On the fifth days after treatment, the levels of serum albumin, prealbumin levels in the study group increased more than before treatment, the levels of aspartate aminotransferase, Cystatin C and troponin I, serum C-reactive protein and interleukin-6 declined, but the patients of the study group improved better than those of the control group, there were significant differences between two group （P〈0.05） .Between two groups, the vomiting rate, gastric retention incidence, insulin resistance levels, average blood glucose value, ICU length of hospital stay, total cost of hospitalization were decreased, the differences between two groups had statistical significance （ P〈0.05 ） .Conclusion： The patients with I type cardiorenal syndrome given low doses of enteral nutrition will improve the protection of organ function and nutrition level.Further analysis of the reasons may be related to low dose of enteral nutrition for the protection of intestinal function, reduce inflammatory reaction of the body.