超早期滋养性肠内营养联合高压氧治疗急性缺血性脑卒中的临床疗效

A Effect of ultra-early nourishing enteral nutrition combined with hyperbaric oxygen therapy on clinical outcome

目的:探究超早期滋养性肠内营养(EN)联合高压氧治疗(HBOT)对急性缺血性脑卒中(AIS)患者临床疗效及血清Sestrin2蛋白(Sestrin2)、人帕金森蛋白(PARK7)的影响。方法:按照治疗方法不同将106例AIS患者分为观察组(n=51)和对照组(n=55)。观察组行超早期滋养性EN联合HBOT治疗;对照组行常规EN联合HBOT治疗。比较两组的神经功能缺损评分(NIHSS)、改良Rankin评分(mRS)、外周血营养指标[白蛋白(ALB)、前白蛋白(PA)和血红蛋白(Hb)]、Sestrin2/PARK7表达水平及不良反应发生情况。结果:治疗后,观察组NIHSS、mRS评分均低于对照组(P<0.05),血清ALB、PA及Hb浓度、PARK7、Sestrin2表达水平均高于对照组(P<0.05)。观察组感染、消化道出血的发生率均低于对照组(33.33%vs.52.73%;7.84%vs.23.64%,P<0.05)。结论:超早期滋养性EN联合HBOT治疗AIS效果较好,血清Sestrin2、PARK7的水平降低可能是其中的重要机制。

Objective:To investigate the effects of ultra-early nourishing enteral nutrition(EN)combined with hyperbaric oxygen therapy(HBOT)on clinical outcome and serum Sestrin2 protein(Sestrin2)and human Parkinson s protein(PARK7)in patients with acute ischemic stroke(AIS).Methods:106 patients with AIS were selected and divided into observation group(n=51)and control group(n=55)according to different treatment methods.Observation group were treated with ultra early nourishing EN combined with HBOT,control group were treated with conventional EN combined with HBOT.Neurological deficit score(NIHSS)and modified Rankin score(mRS)were used to evaluate all patients,and peripheral blood nutritional indices[albumin(ALB),prealbumin(PA)and hemoglobin(Hb)],Sestrin2/PARK7 expression levels and the occurrence of adverse events were compared between the two groups.Results:After treatment,NIHSS and mRS Scores in observation group were lower than those in control group,serum ALB,PA,Hb,PARK7 and Sestrin2 expression levels were higher than those in control group(P<0.05).The incidence of infection and gastrointestinal bleeding in the observation group were 33.33%and 7.84%,respectively,which were lower than those in the control group(52.73%and 23.64%),and the difference was statistically significant(P<0.05).Conclusion:Ultra-early nourishing EN combined with HBOT has a good clinical effect on AIS patients,in which the decrease of serum Sestrin2 and PARK7 levels may be an important mechanism of this treatment.