早期富含精氨酸肠内营养支持对重型颅脑损伤患者免疫功能的影响

Effect of early arginine-rich enteral nutrition support on immune function in patients with severe craniocerebral injury

目的 研究早期富含精氨酸肠内营养支持对重型颅脑损伤患者免疫功能的影响。方法 分析2015年6月至2017年6月郑州大学第二附属医院重症医学科收治的重型颅脑损伤患者78例的临床资料，根据患者术后早期接受肠内营养支持的不同分为对照组35例和实验组43例(精氨酸)，主要评价两组患者术后7 d的免疫学指标、营养学指标、术后并发症等。结果 实验组CD4+含量、CD4+/CD8+比例均显著高于对照组，差异均有统计学意义（均P＜0.05）；实验组与对照组相比，IgA、IgG、IgM均有所升高，两组比较差异均有统计学意义（均P＜0.05）；实验组与对照组相比，C-反应蛋白（CRP）、血沉（ESR）、白细胞介素-1（IL-1）、白细胞介素-6（IL-6）均有明显下降，两组比较差异均有统计学意义（P＜0.05）；结论 富含精氨酸肠内营养支持可以有效改善重症颅脑损伤患者的免疫功能。

Objective To study the effect of early arginine-rich enteral nutrition on immune function in patients with severe craniocerebral injury.Methods The clinical data of 78 patients with severe craniocerebral injury treated at our hospital from June,2015 to June,2017 were analyzed.The patients were divided into a control group(n=35)and an experimental group(ARG)(n=43)according to different enteral nutrition supports.7 d after the operation,the immunological inddicators,nutrition indicators,postoperative complications,etc.in both groups were evaluated.Results The CD4+,CD4+/CD8+,IgA,IgG,and IgM were significantly higher and the C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),interleukin-1(IL-1),and interleukin-6(IL-6)were statistically lower in the experimental group than in the control group,with statistical differences(P<0.05).Conclusion Arginine-rich enteral nutrition can effectively improve the immune function of patients with severe craniocerebral injury.