不同营养干预方法对炎症性肠病患者的治疗效果和营养状态的影响

Comparison of therapeutic effects of different nutritional interventions in patients with inflammatory bowel disease and their effects on nutritional status

目的探讨不同营养干预方法对炎症性肠病(IBD)患者的治疗效果和营养状态的影响。方法选择2018年1月至2019年4月上海市杨浦区中心医院收治的IBD患者86例作为研究对象,采用随机数表法分为对照组和观察组各43例。两组患者均给予常规方法治疗,对照组采用肠外营养干预,观察组在对照组基础上联合肠内营养干预,两组均完成4周治疗,治疗完毕后对患者效果进行评估,比较两组患者的临床活动指数(CAI)、内镜活动指数(EAI)、D乳酸、内毒素、营养状态[白蛋白(ALB)、前白蛋白(PA)及转铁蛋白(TF)]。结果治疗4周后,观察组患者的CAI和EAI评分分别为(1.25±0.19)分、(3.23±0.12)分,明显低于对照组的(2.65±0.21)分、(5.20±0.21)分,D乳酸和内毒素水平分别为(3.38±0.49)mg/L、(13.21±0.63)ng/L,明显高于对照组的(2.51±0.42)mg/L、(9.46±0.57)ng/L,差异均有统计学意义(P<0.05);治疗4周后,观察组患者的ALB、PA和TF水平分别为(47.49±5.74)g/L、(296.98±7.84)mg/L和(2.59±0.73)g/L,明显高于对照组的(36.42±4.09)g/L、(256.11±5.97)mg/L和(2.25±0.69)g/L,差异均有统计学意义(P<0.05)。结论肠内营养联合肠外营养应用于炎症性肠病中能减少患者的临床症状,改善肠黏膜通透性和营养状态,值得临床推广应用。

Objective To explore the effect of different nutritional intervention methods on the therapeutic effect and nutritional status of patients with inflammatory bowel disease.Methods A total of 86 patients with inflammatory bowel disease,who admitted to Shanghai Yangpu District Central Hospital from January 2018 to April 2019,were selected and divided into the control group and observation group according to random number table method,with 43 patients in each group.Both groups of patients were treated with conventional methods.The control group received parenteral nutrition intervention.The observation group applied enteral nutrition intervention on the basis of the control group.Both groups completed 4 weeks of treatment.After treatment,the patients’effects were evaluated and the patient’s clinical activity index(CAI),endoscopic activity index(EAI),D lactate,endotoxin,nutritional status(albumin(ALB),prealbumin(PA),and transferrin(TF))of the two groups were compared.Results After 4 weeks of treatment,the CAI and EAI scores of the observation group were(1.25±0.19)points and(3.23±0.12)points,which were significantly lower than corresponding(2.65±0.21)points and(5.20±0.21)points of the control group(P<0.05).The levels of D lactate and endotoxin were(3.38±0.49)mg/L and(13.21±0.63)ng/L,which were significantly higher than corresponding(2.51±0.42)mg/L and(9.46±0.57)ng/L of the control group(P<0.05).4 weeks after treatment,the ALB,PA and TF levels of the observation group were(47.49±5.74)g/L,(296.98±7.84)mg/L,and(2.59±0.73)g/L,respectively,which were significantly higher than corresponding(36.42±4.09)g/L,(256.11±5.97)mg/L,and(2.25±0.69)g/L of the control group(all P<0.05).Conclusion In the treatment of inflammatory bowel disease,enteral nutrition combined with parenteral nutrition can reduce the clinical symptoms of patients,improve the permeability of the intestinal mucosa and nutritional status,which is worthy of clinical application.