不同肠内营养制剂用于2型糖尿病患者对血糖及血清UA、PA、ALB的影响

Effects of three different enteral nutrition preparations on blood glucose and serum UA,PA and ALB in patients with type 2 diabetes mellitus

目的探究康全力、能全力与瑞能三种不同肠内营养制剂用于2型糖尿病(T2DM)患者对血糖及血清尿酸(UA)、前白蛋白(PA)、白蛋白(ALB)等的影响。方法选取2020年1月至2023年3月于涟水县人民医院重症医学科内分泌与代谢性疾病科治疗的99例T2DM患者为研究对象,按非随机临床同期对照研究及患者自愿原则分为康全力组、能全力组和瑞能组,每组各33例。三组患者分别给予康全力、能全力和瑞能三种不同肠内营养制剂治疗,均连续治疗2个月,比较糖代谢、营养指标、血脂、炎症因子水平和不良反应发生情况。结果治疗后三组糖代谢指标均显著降低,其中康全力组患者治疗后糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2hPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)与能全力组和瑞能组相比均显著降低(P<0.05);治疗后三组血清UA明显下降,PA和ALB水平明显升高(P<0.05),但组间差异无统计学意义(P>0.05);治疗后三组HDL-C均显著升高,康全力组LDL-C、TC和TG均显著降低(P<0.05),能全力组、瑞能组LDL-C、TC和TG未见显著改变(P>0.05),其中康全力组治疗后HDL-C与另外两组相比显著高,LDL-C与另外两组相比显著低,TC和TG与瑞能组相比显著低(P<0.05);治疗后三组IL-6、CRP水平与治疗前相比均显著降低(P<0.05),治疗后康全力组、能全力组IL-6和CRP水平与瑞能组相比显著低(P<0.05);治疗后康全力组、能全力组和瑞能组的不良反应发生总概率为12.12%、21.21%和15.15%,差异无统计学意义(P>0.05)。结论康全力在调节糖脂代谢、缓解炎症反应方面效果较其他肠内营养制剂更突出。

Objective To investigate the effects of three different enteral nutrition preparations(TPF-DM,Nutrison Liquid and Supportan)on blood glucose and serum uric acid(UA),prealbumin(PA)and albumin(ALB)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 99 patients with T2DM admitted to Lianshui County People's Hospital from January 2020 to March 2023 were selected as the study subjects.They were divided into the TPF-DM group,the nutrison liquid group and the supportan group based on the principle of non-randomized clinical controlled trials and voluntary principle,with 33 patients in each group.The three groups of patients were treated with TPF-DM,nutrison liquid and supportan,respec-tively.All patients underwent 2 consecutive months of treatment.Glucose metabolism,nutritional indicators,blood lipids,inflammatory factor levels,and the incidence rates of adverse reactions were compared among the groups.Results After treatment,glucose metabolism indicators in the three groups were significantly re-duced(P<0.05).After treatment,glycated hemoglobin(HbA1c),fasting blood glucose,2-hour postprandial blood glucose(2hPG),fasting insulin(FINS)and homeostasis model assessment of insulin resistance(HOMA-IR)in the TPF-DM group were significantly lower than those in the other two groups(P<0.05).Af-ter treatment,serum UA levels in the three groups decreased significantly,while the levels of PA and ALB in-creased significantly(P<0.05).There was no significant difference among the groups(P>0.05).After treat-ment,HDL-C levels in the three groups increased significantly.The levels of LDL-C,TC and TG in the TPF-DM group were significantly reduced(P<0.05),but the levels of LDL-C,TC,and TG the other two groups showed no significant changes(P>0.05).After treatment,HDL-C level in the TPF-DM group was sig-nificantly higher than those in the other two groups.The LDL-C level was significantly lower than those in the other two groups,and the levels of TC and TG were significantly lower than those in the supportan group(P<0.05).After treatment,the levels of IL-6 and CRP in the three groups were significantly reduced(P<0.05).The levels of IL-6 and CRP in the TPF-DM group and the nutrison liquid group were significantly lower than those in the supportan group(P<0.05).The total incidence of adverse reactions in the TPF-DM group,nutri-son liquid group and supportan group were 12.12%,21.21%and 15.15%,without significant difference among the groups(P>0.05).Conclusion Kangquanli has proven to be more effective than other enteral nutrition preparations in regulating glucose and lipid metabolism,and alleviating inflammatory responses.