不同肠内营养混悬液对老年重症肺炎患者营养及预后的影响

Effects of different enteral nutrition suspensions on nutrition and prognosis in elderly patients with severe pneumonia

目的 探讨不同肠内营养混悬液对老年重症肺炎(SP)患者血糖、营养状况及临床预后水平的影响。方法 选取2020-03-07-2022-06-05修武县人民医院老年SP患者102例作为研究对象,采用随机数字表法分为瑞代组(n=51)和伊力佳组(n=51)。2组每日营养液的供应量根据患者理想体质量计算,瑞代组经鼻胃管匀速滴入瑞代,伊力佳组经鼻胃管匀速滴入伊力佳,记录并对比2组老年患者血糖水平、营养状况、临床预后。对于收集的统计学数据,符合正态分布的计量资料,组内干预前后比较采用单因素协方差分析。结果 伊力佳组干预2周后平均血糖值(GLUave)(8.49±0.54) mmol/L、血糖变异系数(GLUcv)(20.36±3.21)、最高血糖值(GLUmax)(12.08±1.26) mmol/L水平,低于瑞代组的(10.13±0.72) mmol/L、(24.72±4.75)、(14.37±1.84) mmol/L,差异有统计学意义,t值分别为13.013、5.431和7.333,均P<0.05。伊力佳组干预2周后总蛋白(TP)水平为(64.42±2.87) g/L,高于瑞代组的(62.19±2.53)g/L;转铁蛋白(TRF)水平为(2.25±0.76)g/L,高于瑞代组的(1.93±0.54)g/L;血红蛋白(Hb)水平为(124.53±10.05)g/L,高于瑞代组的(120.32±9.31)g/L,差异有统计学意义,F值分别为707.107、53.541和14.958,均P<0.001。伊力佳组干预2周后临床肺部感染评分(CPIS)为(2.41±1.33)分,低于瑞代组的(4.31±1.21)分;急性生理与慢性健康评分(APACHEⅡ)评分为(10.86±1.73)分,低于瑞代组的(16.47±4.28)分;CD3^(+)水平为(67.11±5.62)%,高于瑞代组的(58.35±4.21)%;CD4^(+)水平为(38.41±3.46)%,高于瑞代组的(34.03±3.15)%,差异有统计学意义,F值分别为468.366、510.724、1451.865和788.886,均P<0.001。结论 肠内营养混悬液伊力佳对SP患者进行营养干预,可改善营养状况,调节临床预后,调控血糖水平,提高临床疗效。

Objective To explore the effects of different enteral nutrition suspensions on blood glucose, nutritional status and clinical prognosis in elderly patients with severe pneumonia(SP).Methods A total of 102 elderly SP patients in Xiuwu County People's Hospital from 2020-03-07 to 2022-06-05 were selected as the research objects.They were divided into Ruidai group(n=51) and Yilijia group(n=51) by random number table method.The daily nutrient solution supply of the two groups was calculated according to the ideal body mass of patients.Rudai group was given uniform drops of Rudai through nasogastric tube, while Ilqar group was given uniform drops of Ilqar through nasogastric tube.Blood glucose level, nutritional status and clinical prognosis of the two groups were recorded and compared.The collected statistical data and measurement data were consistent with normal distribution, univariate covariance analysis was used for intra-group comparison before and after intervention.Results After 2 weeks of intervention, the average blood glucose value(GLUave)(8.49±0.54) mmol/L,the coefficient of variation(20.36±3.21) and the highest blood glucose value(GLUmax)(12.08±1.26) mmol/L in Yilika group were lower than those in Rudai group(10.13±0.72).mmol/L,(24.72±4.75),(14.37±1.84) mmol/L,and the difference was statistically significant(t values were 13.013,5.431 and 7.333,all P<0.05).After 2 weeks of intervention, the total protein(TP) level of Illika group was(64.42±2.87) g/L,higher than that of Rudai group(62.19±2.53) g/L.The level of transferrin(TRF) was(2.25±0.76) g/L,higher than that in Rudai group(1.93±0.54)g/L.Hemoglobin(Hb)level was(124.53±10.05)g/L higher than that in Rudai group(120.32±9.31)g/L,and the difference was statistically significant(Fvalues were 707.107,53.541and 14.958,all P<0.001).After 2weeks of intervention,the clinical pulmonary infection score(CPIS)of Illika group was(2.41±1.33)points,which was lower than that of Rudai group(4.31±1.21)points.Acute physiological and chronic health score(APACHEⅡ)was(10.86±1.73)lower than those in Rudai group(16.47±4.28).The level of CD3^(+) was(67.11±5.62)% higher than that in Rudai group(58.35±4.21)%.CD4^(+) level was(38.41±3.46)% higher than(34.03±3.15)%in Rudai group,and the difference was statistically significant(Fvalues were 468.366,510.724,1451.865and 788.886,all P0.001).Conclusion Nutritional intervention of enteral nutrition suspension Ilicar in SP patients can improve nutritional status,regulate clinical prognosis and blood glucose level and improve clinical efficacy.