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投稿时间：2019-04-14 网络发布日期：2019-12-23
投稿时间：2019-04-14 网络发布日期：2019-12-23
中文摘要: 目的 探讨肠内营养支持对老年慢性阻塞性肺病(COPD)急性加重期并发呼吸衰竭患者血清指标和心肺功能的影响。方法 回顾性分析2016年1月1日至2018年10月31日在中国人民解放军东部战区空军医院干部病房治疗的COPD急性加重期并发呼吸衰竭患者80例,患者随机分为两组,40例肠内营养组和40例对照组(常规饮食),观察比较治疗前后患者的营养指标、免疫指标、心肺功能及住院情况。结果 营养指标:观察组治疗后的转铁蛋白(TF)、血清白蛋白(ALB)、前白蛋白(PA)含量较治疗前显著升高(P<0.05),且较对照组治疗后显著升高(P<0.05)。免疫指标:观察组治疗后的超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)含量较治疗前显著降低(P<0.05),血淋巴细胞总数(TLC)、免疫球蛋白A(IgA)、IgG含量较治疗前显著升高(P<0.05),各指标的改善优于对照组。心肺功能:观察组治疗后患者N末端前体B型利钠肽（NT-proBNP）、氧耗量(VO2)、二氧化碳生成量(VCO2)、呼吸商(RQ)、每分钟通气量(VE)显著降低(P<0.05),左心室射血分数(LVEF)、第一秒用力呼气容积(FEV1)、FEV1/FVC明显升高(P<0.05)。观察组患者治疗后的抗菌药物使用天数、住院天数较对照组治疗后显著降低(P<0.05)。结论 肠内营养在对老年COPD急性加重期合并呼吸衰竭患者的治疗上有显著效果,能够有效改善病人的营养状态,提高机体免疫能力,增强患者心肺功能。
Abstract:Objective To investigate the effect of enteral nutrition support on serum index and cardiopulmonary function in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) combined with respiratory failure. Methods A retrospective analysis was performed in 80 patients with acute exacerbation of COPD and respiratory failure treated in the cadre ward of the Air Force Hospital of Eastern Theater Command of Chinese People′s Liberation Army from January 1st,2016 to October 31st,2018.The patients were randomly divided into observation group and control group(n=40,each).Based on the routine treatment,enteral nutrition support was given in observation group,and regular diet was given in control group.The nutritional index,immune index,cardiopulmonary function and hospitalization were observed and compared between two groups before and after treatment. Results After treatment,the levels of transferrin (TF),serum albumin (ALB) and prealbumin (PA) in observation group were significantly higher than those before treatment and those in control group (all P<0.05);the levels of high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α) in observation group were significantly lower than those before treatment (P<0.05),and the total number of blood lymphocytes (TLC),immunoglobulin A (IgA) and IgG were significantly higher than those before treatment (all P<0.05).Compared with control group,the above indicators were significantly improved in observation group.After treatment,N-terminal pro-B-type natriuretic peptide (NT-proBNP),oxygen consumption (VO2),carbon dioxide production (VCO2),respiratory quotient (RQ),ventilation per minute (VE) were significantly lower than those before treatment (P<0.05),and left ventricular ejection fraction (LVEF),forced expiratory volume in the first second (FEV1),and FEV1/FVC significantly increased in observation group (P<0.05).The time of antibiotics using and hospital stay significantly decreased in observation group compared with control group (P<0.05). ConclusionOn the treatment of elderly patients with acute exacerbations of COPD combined with respiratory failure,enteral nutrition has an obvious effect and can significantly improve the nutritional status,immunity and cardiopulmonary function of patients.
keywords: Enteral nutrition support Elderly Chronic obstructive pulmonary disease with acute exacerbation Respiratory failure Nutritional index Immune index Cardiopulmonary function
文章编号： 中图分类号：R 563.9,R 459.3 文献标志码：B
基金项目:
| 作者 | 单位 |
| 苏炜1 | 1.中国人民解放军东部战区空军医院干部病房,江苏 南京 210000 |
| 钱娟2 | 2.南京医科大学第二附属医院儿科,江苏 南京 210000 |
| 殷锐1 | 1.中国人民解放军东部战区空军医院干部病房,江苏 南京 210000 |
| 刘芳1 | 1.中国人民解放军东部战区空军医院干部病房,江苏 南京 210000 |
| Author Name | Affiliation |
| SU Wei*,QIAN Juan,YIN Rui,LIU Fang | *Cadre Ward of Air Force Hospital of Eastern Theater Command of Chinese People′s Liberation Army,Nanjing,Jiangsu 210000,China |
引用文本：
苏炜,钱娟,殷锐,等.肠内营养支持对老年慢性阻塞性肺疾病急性加重期并发呼吸衰竭患者血清指标和心肺功能的影响[J].中国临床研究,2019,32(12):1699-1702.
苏炜,钱娟,殷锐,等.肠内营养支持对老年慢性阻塞性肺疾病急性加重期并发呼吸衰竭患者血清指标和心肺功能的影响[J].中国临床研究,2019,32(12):1699-1702.