肠内营养混悬液(TPF-DM)对超高龄2型糖尿病病人营养、糖脂代谢及免疫功能的影响

The effects of enteral nutritional suspension(TPF-DM)on nutrition,glucose and lipid metabolism and immune function in super aged patients with Type 2 diabetes mellitus

目的:评估肠内营养混悬液(TPF-DM)(diason 0.75 kcal/mL)对超高龄(≥90岁)2型糖尿病病人营养、糖脂代谢及免疫功能的影响。方法:取42例超高龄老年2型糖尿病病人[90.2~105.8岁,平均年龄(94.3±5.9)岁]作为研究对象,分别于TPF-DM治疗前及治疗6月后测量其营养MNA评分、体质指数(BMI)、上臂中点围(MAC)、三头肌皮褶厚度(TSF);并于治疗前后分别检测其外周血ALB、总维生素D、血红蛋白、HbA1c、TC、TG、LDL-C、CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、CD4^(+)/CD8^(+)和NK细胞水平,并比较上述两组指标治疗前后间的差异。结果:与治疗前相比较,超高龄2型糖尿病人给予TPF-DM,6个月后其外周血血红蛋白明显上升(P<0.05);MNA、BMI、TSF值、ALB、血清总维生素D、CD3^(+)T细胞、CD4^(+)T细胞和CD4^(+)/CD8^(+)上升更为显著(P<0.01);外周血HbA1和TG水平明显下降(P<0.01)。结论:超高龄体弱老年糖尿病病人的处于营养不良及免疫功能低下状态,TPFDM能够明显改善其营养、糖脂代谢及免疫功能。

Objective:To evaluate the effect of enteral nutritional suspension(TPF-DM)(diason 0.75 kcal/mL) on nutrition,glucose and lipid metabolism and immune function in super aged patients with type 2 diabetes mellitus(T2DM).Methods:Forty two super aged patients with T2DM[90.2~105.8 years old,average age(94.3±5.9)years old]were selected as research objects.The nutritional MNA score,BMI,MAC and TSF were measured respectively before and after TPF-DM treatment for six months,and also the levels of peripheral blood ALB,total vitamin D,hemoglobin,HbA1c,TC,TG,LDL-C,CD3^(+)T cells,CD4^(+)T cells,CD8^(+)T,CD4^(+)/CD8^(+)and NK cells were measured respectively.Then the differences were compared between the before and after treatment.Results:Treatmented by TPFDM for six months,the levels of hemoglobin in the peripheral serum of the super aged patients with T2DM were significantly higher(P<0.05);MNA,BMI,TSF,ALB,total vitamin D an,CD3^(+)T cells,CD4^(+)T cells and CD4^(+)/CD8^(+)were more significantly higher(P<0.01);and the levels of HbA1 and TG in peripheral blood were significantly lower(P<0.01)than those before the treatment.Conclusion:The frail super aged patients with T2DM are in a state of malnutrition and low immune function,TPF-DM can significantly improve their nutrition,glucose and lipid metabolism and immune function.