谷氨酰胺肠内营养对结核患者免疫与肠道屏障功能的影响

Effect of Glutamine Enteral Nutrition on Immunity and Intestinal Barrier Function of Tuberculosis Patients

目的研究谷氨酰胺肠内营养对结核患者免疫与肠道屏障功能的影响,为指导临床实践方案提供支持。方法便利选择该院于2018年12月—2020年6月间收治的54例结核病患者为研究对象,采用随机数字表法对患者平均分组后,研究组患者接受抗结核治疗+谷氨酰胺肠内营养干预,对照组患者单纯接受抗结核治疗,评价两组患者免疫功能与肠道屏障功能差异。结果比较两组患者治疗后的体液免疫指标数据,研究组治疗后的CD4^(+)、CD8^(+)分别为(44.36±1.08)%、(23.81±0.35)%,优于对照组,差异有统计学意义(t=7.352、5.493,P<0.05)。研究组患者治疗后的血清白蛋白(ALB)、C反应蛋白(CRP)、免疫球蛋白(IgG)分别为(39.74±1.06)g/L、(26.77±1.68)×10^(3)μg/L、(26.41±3.42)g/L,优于对照组,差异有统计学意义(t=8.063、10.438、10.357,P<0.05)。患者外周血DAO指标显示,研究组患者治疗后优于治疗前,差异有统计学意义(P<0.05)。结论在结核病患者临床干预过程中,除了常规的抗结核治疗外,采取谷氨酰胺肠内营养干预的治疗方法可以改善患者的免疫与肠道屏障功能,是一种科学有效的干预手段。

Objective To study the effect of glutamine enteral nutrition on the immune and intestinal barrier function of tuberculosis patients,and to provide support for guiding clinical practice programs.Methods 54 cases of tuberculosis patients admitted to the hospital between December 2018 and June 2020 were conveniently selected as the research objects.After the patients were divided into groups by random number table method,the study group received anti-tuberculosis treatment+glutamine intestine internal nutrition intervention,the control group received only anti-tuberculosis treatment,and the difference in immune function and intestinal barrier function between the two groups was evaluated.Results Comparing the humoral immune index data of the two groups of patients after treatment,the CD4^(+)and CD8^(+)after treatment of the study group were(44.36±1.08)%and(23.81±0.35)%,which were better than those of the control group,the difference was statistically significant(t=7.352,5.493,P<0.05).The serum albumin(ALB),C-reactive protein(CRP),and immunoglobulin(IgG)of the study group after treatment were(39.74±1.06)g/L,(26.77±1.68)×10^(3)μg/L,(26.41±3.42)g/L,better than the control group,the difference was statistically significant(t=8.063,10.438,10.357,P<0.05).The DAO indicators of the peripheral blood of the patients showed that the patients in the study group were better after treatment than before treatment,the difference was statistically significant(P<0.05).Conclusion In the process of clinical intervention of tuberculosis patients,in addition to the conventional anti-tuberculosis treatment,the treatment of enteral nutrition intervention with glutamine can improve the patient's immune and intestinal barrier function,which is a scientific and effective intervention method.