钙卫蛋白在评估急危重症患者中肠内营养不耐受的应用价值

Application value of calprotectin in evaluating intolerance to enteral nutrition in critically ill patients

目的:观察钙卫蛋白在评估急危重症患者肠内营养不耐受的应用价值。方法:回顾性选取2021年12月1日至2023年2月1日赣州市人民医院接收的50例急危重症患者,根据急性生理学及慢性健康状况评分量表(Acute physiology and chronic health evaluation scoring system,APACHE)及序贯器官衰竭估计评分量表(Sequential organ failure assessment scale,SOFA)进行筛选分为实验组(喂养不耐受)和对照组(喂养耐受),每组25例,其中实验组给予早期干预改善肠内营养不耐受,对照组则不干预,观察两组于入院时(BF)、发生营养耐受第一天(FD1)、发生营养耐受第五天(FD5)之间钙卫蛋白浓度、感染情况(SOFA评分)、病情恢复情况(APACHE评分)及在ICU住院时长,分析钙卫蛋白与急危重症患者肠内营养不耐受、感染情况及病情之间的关系。结果:实验组FD5高于对照组,但两组BF、FD1比较无明显差异(P>0.05);实验组SOFA评分、APACHE评分均高于对照组(P<0.05),且实验组ICU住院时长多于对照组(P<0.05);经干预后实验组FD5、SOFA评分、APACHE评分均降低(P<0.05);经Pearman相关性分析后得知FD5与SOFA评分、APACHE评分呈正相关(P<0.05)。结论:钙卫蛋白(FD5)与SOFA评分、APACHE评分均具有明显关系,因此认为钙卫蛋白可替代内镜检查,可作为判断急危重症患者肠内营养是否耐受及病情程度的重要评估指标。

Objective:To observe the application value of calprotectin in evaluating intolerance to enteral nutrition in critically ill patients.Methods:Fifty critically ill patients admitted to Ganzhou People's Hospital from December 1,2021 to February 1,2023 were reviewed.According to the Acute Physiology and Chronic Health Evaluation II(APACHE)and sequential Organ Failure Assessment scale(SOFA),the patients were divided into experimental group(feeding intolerance)and control group(feeding tolerance),with 25 patients in each group.The experimental group was given early intervention to improve intolerance to enteral nutrition,while the control group was not given intervention.The concentrations of calprotectin at admission(BF),on the first day of feeding tolerance(FD1)and the fifth day of feeding tolerance(FD5),infection status(SOFA score),recovery status(APACHE score),and length of ICU stay in the two groups were observed.The relationship between calprotectin and intolerance to enteral nutrition,infection and condition in critically ill patients was analyzed.Results:FD5 in the experimental group was higher than that in the control group,but there was no significant difference in BF or FD1 between the groups(P>0.05).The SOFA score and APACHE score of the experimental group were higher than those of the control group(P<0.05).ICU stay of the experimental group was longer than that of the control group(P<0.05).After intervention,FD5,SOFA score and APACHE score of the experimental group decreased(P<0.05).spearman correlation analysis found that FD5 was positively correlated with SOFA score and APACHE score(P<0.05).Conclusion:Calprotectin(FD5)is closely related to the SOFA score and APACHE.Therefore,calprotectin can replace endoscopy,and serve as an important indicator for assessing the tolerance to enteral nutrition and the condition of critically ill patients.