肠内营养联合双歧杆菌三联活菌对老年慢性心力衰竭病人心功能及微炎症状态的影响

Effect of enteral nutrition combined with Bifidobacterium triple viable on cardiac function and microinflammation in elderly patients with chronic heart failure

目的探究肠内营养联合双歧杆菌三联活菌对老年慢性心力衰竭病人心功能及IL-1β、IL-6、血清淀粉样蛋白A(SAA)水平的影响。方法选取2018年11月至2021年5月深圳市人民医院收治的210例老年慢性心力衰竭病人作为研究对象,随机分为肠内营养组、肠内营养联合双歧杆菌三联活菌组(联合组)及对照组,每组70例。肠内营养组在心力衰竭基础治疗上加用肠内营养治疗,联合组在肠内营养组基础上加用双歧杆菌三联活菌支持治疗,对照组在心力衰竭基础治疗上给予普通饮食。4周后对比3组病人治疗前后血清营养指标[白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(TF)]、炎症因子(IL-1β、IL-6、SAA)以及心功能[氨基末端脑钠肽前体(NT-proBNP)、缺血修饰白蛋白(IMA)、LVEF]情况。结果联合组治疗后ALB、PA、TF水平高于治疗前及肠内营养组(P<0.05),肠内营养组ALB、PA、TF水平高于治疗前及对照组(P<0.05)。治疗后3组LVEF比较,差异无统计学意义(P>0.05),但高于本组治疗前(P<0.05);联合组IL-1β、IL-6、SAA、NT-proBNP、IMA水平低于治疗前及肠内营养组(P<0.05),肠内营养组IL-1β、IL-6、SAA、NT-proBNP、IMA水平低于治疗前及对照组(P<0.05)。结论肠内营养联合双歧杆菌三联活菌能够通过改善营养状况及调节体内微炎症状态,改善老年慢性心力衰竭病人心功能情况。

Objective To explore the effect of enteral nutrition combined with Bifidobacterium triple viable on cardiac function and the levels of interleukin-1β(IL-1β),interleukin-6(IL-6),serum amyloid A(SAA)in the elderly patients with chronic heart failure.Methods A total of 210 elderly patients with chronic heart failure in Department of Geratology of Shenzhen People’s Hospital from November 2018 to May 2021 were randomly divided into the control group,the enteral nutrition group and the enteral nutrition combined with Bifidobacterium triple viable group(the combination group),with 70 cases in each group.The enteral nutrition group received basic treatment of heart failure and enteral nutrition.The combination group was treated with Bifidobacterium triple viable on the basis of the enteral nutrition group.The control group was given normal diet on the basis of the basic treatment.Four weeks later,the nutritional status indexes including albumin(ALB),prealbumin(PA),transferrin(TF),the levels of inflammatory factors including IL-1β,IL-6,SSA and cardiac function indexes including N-terminal pro-brain natriuretic peptide(NT-proBNP),ischemia-modified albumin(IMA)and left ventricular ejection fraction(LVEF)of the three groups before and after treatment were compared.Results The levels of ALB,PA,TF in the combination group after treatment were higher than those before treatment and those in the enteral nutrition group(P<0.05).The levels of ALB,PA,TF of the enteral nutrition group after treatment were higher than those before treatment and those in the control group(P<0.05).The level of LVEF in the three groups was increased after treatment(P<0.05).There was no significant difference in LVEF among the three groups after treatment(P>0.05).After treatment,the levels of IL-1β,IL-6,SSA and NT-proBNP,IMA were lowest in the combination group,followed by the enteral nutrition group and the control group(P<0.05).Conclusions Enteral nutrition combined with Bifidobacterium triple viable can improve the heart function of the elderly patients with chronic heart failure by improving the nutritional status and regulating the micro-inflammatory state.