肠内营养支持对急性心肌梗死患者胃肠道保护及Treg/Th17免疫平衡的影响

Effects of enteral nutrition support on gastrointestinal protection and Treg/Th17 immune balance in patients with acute myocardial infarction

目的探讨肠内营养支持对急性心肌梗死(AMI)患者的影响。方法选取2020年3月至2021年3月该院AMI患者104例,采用随机抽签法分为对照组(52例)和观察组(52例)。对照组予以肠外营养支持,观察组予以肠内营养支持。比较2组胃肠道保护效果、胃肠功能恢复情况、免疫平衡状态、并发症发生情况及营养状态。结果2组干预前二胺氧化酶(DAO)、D-乳酸水平比较,差异无统计学意义(P>0.05)。干预后,2组DAO、D-乳酸水平低于干预前,且观察组各指标低于对照组,差异有统计学意义(P<0.05)。观察组恶心呕吐缓解时间、腹泻缓解时间、经口进食恢复时间、肠鸣音恢复时间短于对照组,差异有统计学意义(P<0.05)。2组干预前Th17、Treg水平及Th17/Treg值比较,差异无统计学意义(P>0.05)。观察组干预后Th17、Treg水平及Th17/Treg值与对照组比较,差异有统计学意义(P<0.05)。2组并发症发生率比较,差异有统计学意义(P<0.05)。2组干预前清蛋白、血红蛋白、转铁蛋白、前清蛋白水平比较,差异无统计学意义(P>0.05)。干预后,2组清蛋白、血红蛋白、转铁蛋白、前清蛋白水平高于干预前,且观察组各指标高于对照组,差异有统计学意义(P<0.05)。结论肠内营养支持能增强对AMI患者的胃肠道保护,促进患者胃肠道功能快速恢复,同时能改善患者免疫状态和营养状态,降低并发症发生率。

Objective To explore the impact of enteral nutrition support on patients with acute myocardial infarction(AMI).Methods A total of 104 AMI patients in the hospital from March 2020 to March 2021 were selected and randomly divided into the control group(52 cases)and the observation group(52 cases).The control group received parenteral nutrition support,and the observation group received enteral nutrition support.The gastrointestinal protection effect,gastrointestinal function recovery,immune balance,incidence of complications,and nutritional status were compared between the two groups.Results There were no statistically significant differences in the levels of diamine oxidase(DAO)and D-lactate before intervention between the two groups(P>0.05).After intervention,the levels of DAO and D-lactate in the two groups were lower than those before intervention,and the indicators in the observation group were lower than those in the control group,and the differences were statistical significance(P<0.05).The remission time of nausea and vomiting,the remission time of diarrhea,the recovery time of oral feeding and the recovery time of bowel sounds in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in Th17,Treg levels,and Th17/Treg ratio before intervention between the two groups(P>0.05).After intervention,the levels of Th17,Treg and Th17/Treg values in the observation group were significantly different from those in the control group(P<0.05).There was statistically significant difference in the incidence of complications between the two groups(P<0.05).There were no statistically significant differences in the levels of albumin,hemoglobin,transferrin,and prealbumin before intervention between the two groups(P>0.05).After intervention,the levels of albumin,hemoglobin,transferrin,and prealbumin in the two groups were higher than those before intervention,and the indicators in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Enteral nutrition support can enhance the protection of gastrointestinal tract in AMI patients,promote the rapid recovery of gastrointestinal function,improve the immune and nutritional status,and reduce the incidence of complications.