肠内营养支持对慢性阻塞性肺疾病机械通气患者免疫功能的影响

目的探讨慢性阻塞性肺疾病并发呼吸衰竭患者机械通气时早期肠内营养支持治疗对患者免疫功能的影响。方法采取随机、对照试验方法,27例患者随机分为肠内营养治疗组(EN组)和对照组,治疗7天。观察治疗前后血清白蛋白,免疫球蛋白IgA、IgG、IgM,血液淋巴细胞总数(TLC)及T细胞亚群等的变化。结果EN组血淋巴细胞总数、血清白蛋白、IgA、IgG浓度、CD3(%)、CD4(%)及CD4/CD8较治疗前显著升高(P<0.05,P<0.01)。治疗后两组比较,EN组血淋巴细胞总数、血清白蛋白、IgA、IgG浓度、CD3(%)、CD4(%)及CD4/CD8显著高于对照组(P<0.05,P<0.001)。结论对于慢性阻塞性肺疾病机械通气患者,及时合理的肠内营养支持治疗有助于改善机体的免疫功能,提高综合治疗的疗效。

Effect of Enteral Nutrition Support on Immune Function in Chronic Obstructive Pulmonary Disease Patients Undergoing Mechanic Ventilation

Objective To study the effect of early enteral nutrition support on immune function in chronic obstructive pulmonary disease(COPD)patients undergoing mechanic ventilation.Methods Twenty-seven cases of mechanical ventilated patients with COPD were randomly divided into two groups:enteral nutrition(EN)group(n=14)and the control group(n=13).The study period was 7 days.Serum levels of albumin and immunoglobulins(IgA,IgG,and IgM),total lymphocyte counts(TLC),and T-cell subpopulations were detected and compared before and after treatment.Results In EN group,blood total lymphocyte counts,serum levels of albumin,IgA,IgG,and percentage of CD3 significantly increased after 7 days(P<0.05);percentage of CD4 and the ratio of CD4/CD8 also significantly increased after 7 days(P<0.01).Total lymphocyte counts,serum albumin,percentage of CD4,and the ratio of CD4/CD8 were significantly higher in EN group than those in the control group after 7 days(P<0.001);serum levels of IgA,IgG and percentage of CD3 were also significantly higher in EN group than those in the control group(P<0.05).Conclusion In mechanical ventilated patients with COPD,timely and reasonable enteral nutrition support are helpful to improve the immune function,and thus to improve the whole treatment effectiveness.