高能肠内营养乳剂对重症心力衰竭患者N末端B型利钠肽原及炎性因子的影响

Effects of high energy enteral nutritional emulsion on the levels of N terminal B type natriuretic peptide and inflammatory factors in patients with severe heart failure

目的探讨高能肠内营养对重症心力衰竭患者N末端B型利钠肽原(NT-proBNP)及血清炎性因子的影响。方法选择我科2016年2—8月收治的重症心力衰竭患者60例,随机分为两组。两组在常规治疗心衰同时,常规饮食组自由饮食,高能肠内营养组经口进食高能肠内营养乳剂瑞先。治疗前后检测营养指标及血清炎性因子白介素-6、C-反应蛋白及心功能指标血浆氨基末端脑钠肽前体变化。结果常规饮食组患者治疗前后各项营养指标无改善,心功能及血清炎性因子水平较前改善,差异有统计学意义(P<0.05)。高能肠内营养组患者治疗前后各项营养指标明显改善,心功能及血清炎性因子水平较前明显改善,差异有统计学意义(P<0.05),与常规饮食组比较改善更加明显,差异有统计学意义(P<0.05)。结论重症心力衰竭常规治疗心衰的同时加强肠内营养的支持,可以改善患者的营养状况,降低炎性因子水平,进一步改善心功能。

Objective To investigate the effect of high energy enteral nutrition on N-Terminal B-type natriuretic peptide(NT-proBNP)and serum inflammatory factors in patients with severe heart failure.Methods Sixty patients with severe heart failure were selected from February 2016 to August 2016,randomly divided into two groups.While the two groups received conventional treatment of heart failure,the regular diet group had free diet,and the high-energy enteral nutrition group had high-energy enteral nutrition emulsion through the mouth.Before and after the treatment,the nutritional indicators,the serum inflammatory factor interleukin-6,Changes of C-reactive protein and cardiac function index plasma amino-end brain natriuretic peptide precursor(NT-proBNP)were tested.Results Before and after treatment in patients with normal diet group,the nutritional index did not improve,heart function and serum inflammatory factor levels were improved,the difference was statistically significant(P<0.05).High energy enteral nutrition group before and after treatment in patients with nutritional indexes significantly improved,cardiac function and serum inflammatory factor levels were significantly improved,the difference was statistically significant(P<0.05);and the high energy enteral nutrition group improved more obviously,the difference was statistically significant(P<0.05).Conclusion The routine treatment of heart failure and the support of enteral nutrition in patients with severe heart failure can improve the nutritional status,reduce the level of inflammatory factors and further improve the cardiac function.