不同营养制剂在老年慢性心力衰竭患者治疗中的效果对比

Effects of Different Enteral Nutrition Preparation in the Treatment of Older Patients with Chronic Heart Failure

目的对比分析肠内营养乳剂与短肽型营养制剂在老年慢性心力衰竭患者的使用效果。方法选取2017年5月~2020年2月收治的108例老年慢性心力衰竭患者作为研究对象,按照随机数字表法分为两组,各54例。对照组采用短肽型营养制剂进行营养支持,观察组采用肠内营养乳剂进行营养支持。比较两组干预前、干预1周和2周后营养支持效果[血清转铁蛋白(TRF)、前白蛋白(PA)、白蛋白(ALB)]、糖代谢指标[空腹血糖、重组β细胞营养因子]、心功能指标[左室射血分数(LVEF)、每搏输出量(SV)]、血清B型钠尿肽(BNP)、免疫指标[CD3^(+)、 CD4^(+)、 CD4^(+)/CD8^(+),免疫球蛋白(Ig)A、IgM、IgG]及耐受性。结果干预1周、2周后,观察组血清TRF、PA、ALB、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、IgA、IgM、IgG水平及LVEF、SV均高于对照组(P<0.05).空腹血糖、重组β细胞营养因子及BNP水平均低于对照组(P<0.05),腹泻、胃潴留、电解质异常发生率低于对照组(P<0.05)。结论与短肽型营养制剂相比,采用肠内营养乳剂对老年慢性心力衰竭患者进行营养支持能进一步改善营养支持效果,有助于增强患者心功能,下调血清BNP水平,改善机体免疫功能,且对糖代谢影响较低,患者耐受性更高。

Objective To investigate the effects of enteral nutrition emulsion and short peptide nutrition preparations in the treatment of chronic heart failure(CHF)in older patients.Methods A total of 108 older patients with CHF treated from May 2017 to Februaiy 2020 were selected and divided into a control group and an observation group by random number table,54 cases in each group.The control group received short peptide nutritional preparation for nutritional support,and the observation group received enteral nutrition emulsion for nutritional support.The effects of nutritional support including serum transferrin(TRF),prealbumin(PA),and albumin(ALB);glucose metabolism indicators including fasting blood glucose(FBG),recombinant β-cell nutritional factor;cardiac function indicators including left ventricular ejection fraction(LVEF),stroke volume(SV),serum B-type natriuretic peptide(BNP);immune indices including CD3^(+),CD4^(+),CD4^(+)/CD8^(+),immunoglobulin(Ig)A,IgM,IgG;and tolerance before intervention,after 1 week and 2 weeks of intervention were compared between the two groups.Results After 1 week and 2 weeks of intervention,the serum levels of TRF,PA,ALB,CD3^(+),CD4^(+),CD4^(+)/CD8^(+),IgA,IgM and IgG;LVEF and SV in the observation group were higher than those in the control group(P<0.05).The levels of FBG,recombinant β-cell nutritional factor,and BNP in the observation group were lower than those in the control group(P<0.05).The incidences of diarrhea,gastric retention and electrolyte abnormalities in the observation group were lower than those in the control group(P<0.05).Conclusion Compared with the short peptide nutritional preparations,the enteral nutrition emulsion may further improve the effect of nutritional support and enhance the cardiac function of older patients with CHF,lower the serum BNP level,improve the immune function,has a lower impact on glucose metabolism,and the patient has a higher tolerance.