肠内营养乳剂TPF-D联合微生态制剂对慢性阻塞性肺疾病急性加重期患者心肺功能和营养指标的影响

Effects of enteral nutrition emulsion TPF-D combined with probiotics on cardiopulmonary function and nutritional indexes in patients with AECOPD

目的探讨肠内营养乳剂TPF-D联合微生态制剂对慢性阻塞性肺疾病急性加重期(AECOPD)患者心肺功能及营养指标的影响,为该类患者的治疗提供参考。方法选取2020年7月至2021年5月我院收治的108例AECOPD患者为研究对象,依据随机数表法将患者分为观察组及对照组,各54例。两组患者均接受常规治疗与护理,对照组患者给予肠内营养乳剂TPF-D,观察组患者在对照组的基础上给予微生态制剂,两组患者均治疗2周。比较患者肠黏膜屏障功能指标[肠型脂肪酸结合蛋白(I-FABP)、二胺氧化酶(DAO)]、炎症反应指标[白细胞(WBC)、降钙素原(PCT)、C-反应蛋白(CRP)]、营养指标[白蛋白(ALB)、前白蛋白(PA)]、心肺功能指标[左心室射血分数(LVEF)、氧耗量(VO_(2))、二氧化碳生成量(VCO_(2))、呼吸商(RQ)、每分钟通气量(VE)、NT-proBNP]、消化道并发症发生率(应激性溃疡、腹胀、腹泻、胃潴留、便秘等)。结果观察组患者治疗后I-FABP和DAO水平低于对照组(t=17.533、8.469,均P<0.05)。观察组患者治疗后WBC、CRP和PCT水平低于对照组(t=14.997、18.710、23.197,均P<0.05)。观察组患者治疗后PA和ALB水平高于对照组(t=8.083、7.292,均P<0.05)。观察组患者治疗后LVEF水平高于对照组(t=3.862,P<0.05)。观察组患者治疗后VO_(2)、VCO_(2)、RQ、VE和TN-proBNP水平均低于对照组(t=3.923、12.569、7.292、3.095、10.079,均P<0.05)。观察组患者腹胀、腹泻、胃潴留发生率均低于对照组(χ2=4.441、4.821、4.216,均P<0.05)。结论肠内营养乳剂TPF-D结合微生态制剂有利于改善AECOPD患者黏膜屏障功能,抑制炎症反应,增强患者心肺功能,改善患者营养状态,降低消化道并发症发生率。

Objective To observe the effects of enteral nutrition emulsion TPF-D combined with probiotics on cardiopulmonary function and nutritional indexes in patients with acute exacerbation of chronic bstructive pulmonary disease(AECOPD),and provide a reference for the treatment.Methods A total of 108 AECOPD patients admitted to our hospital from July 2020 to May 2021 were selected and divided into observation group and control group randomly,54 cases in each group.Both groups received conventional treatment and nursing.The patients in the control group were given enteral nutrition agent TPF-D,while those in the observation group was given probiotics on the basis of TPF-D.After 2 weeks of treatment,the intestinal mucosal barrier function[intestinal fatty acid binding protein(I-FABP)and diamine oxidase(DAO)],inflammatory response[WBC,procalcitonin(PCT),C-reactive protein(CRP)],nutritional parameters[ALB and prealbumin(PA)],cardiopulmonary function[left ventricular ejection fraction(LVEF);Oxygen consumption(VO_(2)),car-bon dioxide production(VCO_(2)),respiratory quotient(RQ),ventilate volume per minute(VE)and TN-proBNP],incidence of gastrointestinal complications(stress ulcer,abdominal distension,diarrhea,gastric retention,constipation,etc.)were compared between groups.Results After treatment,the levels of I-FABP and DAO in the observation group were lower than those in the control group(t=17.533,8.469;P<0.05);the levels of WBC,CRP and PCT in the observation group were lower than those in the control group(t=14.997,18.710,23.197;P<0.05);the levels of PA and ALB in the observation group were higher than those in the control group(t=8.083,7.292;P<0.05);the LVEF level in the observation group was higher than that in the control group(t=3.862,P<0.05);the levels of VO_(2),VCO_(2),RQ,VE and TN-proBNP in the observation group were lower than those in the control group(t=3.923,12.569,7.292,3.095,10.079;P<0.05).The incidence of abdominal distension,diarrhea and gastric retention in the observation group was lower than that in the control group(χ2=4.441,4.821,4.216;P<0.05).Conclusion Enteral nutrition emulsion TPF-D combined with probiotics can improve the mucosal barrier function of patients with AECOPD,inhibit inflammatory response,enhance the patient's cardiopulmonary function,improve the nutritional status of patients,and reduce the incidence of alimentary tract complications.