早期肠内营养对急性重症胰腺炎炎性状况、细胞免疫功能及营养状况的影响

Influence of early enteral nutrition on inflammatory status, cellular im-mune function and nutritional status of acute severe pancreatitis

目的探讨早期肠内营养对急性重症胰腺炎炎性状况、细胞免疫功能及营养状况的影响。方法选择2015年10月～2017年11月本院收治的80例急性重症胰腺炎患者作为研究对象,按照随机数字表法分为观察组与对照组,每组各40例。观察组患者实施早期肠内营养,对照组患者给予完全胃肠外营养,比较两组患者干预后的血清蛋白(如转铁蛋白、前白蛋白及白蛋白水平)变化情况,统计两组干预后的炎症性细胞因子[肿瘤坏死因子-α(TNF-α),超敏C反应蛋白(hs-CRP)及白细胞介素-6(IL-6)]水平变化情况及两组干预后的细胞免疫CD4^+、CD8^+及CD4^+/CD8^+水平变化情况。结果观察组干预后的转铁蛋白、前白蛋白及白蛋白水平均显著高于对照组,差异有统计学意义(P<0.05)。观察组干预后的TNF-α、hs-CRP及IL-6水平均低于对照组,差异有统计学意义(P<0.05)。观察组干预后的CD4^+、CD8^+水平均高于对照组,差异有统计学意义(P<0.05)。观察组干预后的CD4^+/CD8^+比值大于对照组,差异有统计学意义(P<0.05)。结论针对急性胰腺炎患者,实施早期肠内营养支持能显著改善患者营养状况,减轻炎性反应,提高机体免疫力。

Objective To investigate the influence of early enteral nutrition on inflammatory status, cellular immune function and nutritional status of acute severe pancreatitis. Methods A total of 80 cases with acute severe pancreatitis admitted in our hospital from October 2015 to November 2017 were selected as research objects and divided into the observation group and the control group according to the random number table method, 40 cases in each group. The observation group was given early enteral nutrition, and the control group was given complete parenteral nutrition. The changes of serum proteins such as transferrin, prealbumin and albumin after intervention were compared between the two groups. The levels of inflammatory cytokines such as tumor necrosis factor-α(TNF-α), hypersensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6) after intervention and the levels of CD4^+, CD8^+ and CD4^+/CD8^+ after intervention were counted. Results After intervention, the levels of transferrin, prealbumin and albumin in the observation group were significantly higher than those in the control group, and the differences were statistically significant (P<0.05). The levels of TNF-α, hs-CRP and IL-6 in the observation group after intervention were significantly higher than those in the control group, and the differences were statistically significant (P<0.05). The levels of CD4^+ and CD8^+ in the observation group after intervention were significantly higher than those in the control group, and the differences were statistically significant (P<0.05). The ratio of CD4^+/CD8^+ in the observation group after intervention was greater than that in the control group, and the difference was statistically significant (P<0.05). Conclusion For patients with acute pancreatitis, early enteral nutrition support can improve the nutritional status and reduce inflammation and improve immunity.