| 摘要: |
| 目的 探讨重症急性胰腺炎早期免疫肠内营养支持的临床疗效。方法 按性别、年龄配伍原则收集104例重症急性胰腺炎患者的临床资料，其中免疫营养组（研究组）与标准营养组（对照组），每组各52例，分别于入院时、入院后第7、14天抽取静脉血，检测血清白蛋白（ALB）、前白蛋白（PA）、转铁蛋白（TFN）、T淋巴细胞亚群（CD3、CD4、CD8、CD4/CD8）、血清免疫球蛋白（IgG、IgA、IgM）等水平。比较两组患者治疗前后APACHE-Ⅱ评分的变化、首次通便时间、腹痛缓解时间、住院天数。结果研究组治疗第7、14天的血清ALB、PA和TFN水平均明显高于对照组，差异均有统计学意义（均P＜0.05）；研究组治疗第7天CD3、CD4、CD4/CD8比值以及IgG、IgM、IgA水平均明显高于对照组，治疗第14天CD3和CD4以及IgM和IgA水平均高于对照组，差异均有统计学意义（均P＜0.05）；研究组治疗第14天APACHE-Ⅱ评分明显低于对照组，且首次通便时间、腹痛缓解时间及住院天数均明显短于对照组（均P＜0.05）；研究组第14天并发症发生率（7.69%）明显低于对照组（19.23%），差异有统计学意义（P＜0.05）。结论重症急性胰腺炎患者进行早期免疫肠内营养支持可调节免疫功能，加快病情恢复。 |
| 关键词: 早期肠内营养 重症急性胰腺炎 免疫功能 |
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| Effects of early enteral immunonutrition on host immune and prognosis in patients with severe acute pancreatitis |
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TANG Kankai, FANG Qiang
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the First Affiliated Hospital，Zhejiang University School of Medicine
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| Abstract: |
| Objective To evaluate the effects of early enteral immunonutrition on the nutritional and immunity status, and the prognosis of patients with severe acute pancreatitis. Methods One hundred and four patients with severe acute pancreatitis were randomly allocated to receive enteral immunonutrition support (study group, n=52) or conventional enteral nutrition support (control group, n=52). Peripheral blood samples were collected at the d1, d7 and d14, and the serum albumin (ALB), transferring (TFN), prealbumin (PA), CD3, CD4, CD8, CD4/CD8, IgG, IgA, IgM were measured. APACHE-Ⅱ score, first laxative time, pain relief time and the days in hospital were recorded. Results The serum ALB, PA and TF levels in study group at d7 and d14 were significantly higher than those in control group (P＜0.05). CD3, CD4, CD4/CD8, IgG, IgM and IgA in study group at d7 were significantly higher than those in control group (P＜0.05); CD3,CD4,IgM and IgA in study group at d14 were significantly higher than those in control group(P＜0.05). APACHE-Ⅱ score, first laxative time, pain relief time and length of hospital stay were better in immunonutrition group than in control group (P＜0.05). The complication rate of study group was significantly lower than thas of control group (P＜0.05). Conclusion Early enteral immunonutrition can enhance immune function, improve nutritional status for patients with severe acute pancreatitis. |
| Key words: Early enteral immunonutrition Severe acute pancreatitis Immune function |
