早期肠内营养对COPD急性加重合并呼吸衰竭患者T细胞亚群及其细胞因子影响.docVIP

早期肠内营养对COPD急性加重合并呼吸衰竭患者T细胞亚群及其细胞因子影响 　　[摘要]目的 探讨早期肠内营养对COPD急性加重合并呼吸衰竭患者T细胞亚群及其细胞因子的影响。方法 将2013年9月～2016年12月因COPD急性加重合并呼吸衰竭于我院呼吸科就诊的86例患者纳入研究并随机分组，均常规采用呼吸机辅助通气，对照组42例在机械通气后24 h采用肠外营养支持；观察组44例采用肠内营养，14 d为1个疗程。比较两组的疗效。结果 治疗后，两组患者的肿瘤坏死因子（TNF-α）、白介素-6（IL-6）等炎症因子水平降低，观察组的数值更低（P0.05），两组患者的CD4+、CD3+、CD4+/CD8+等免疫指标降低，但观察组数值高于对照组（P0.05）。观察组二重感染、肝功能损伤、消化道出血、血糖升高并发症的发生率及死亡率低于对照组（P0.05）。结论 肠内营养尽早应用于COPD急性加重合并呼吸衰竭患者，可促进疾病康复，预防免疫功能损伤，降低并发症发生率，值得推广。 　　[关键词]早期肠内营养；COPD急性加重；呼吸衰竭 　　[中图分类号] R563.9 [文献标识码] A [文章编号] 1674-4721（2017）06（c）-0022-03 　　[Abstract]Objective To investigate the effect of early enteral nutrition on T cell subsets and cytokines in patients with acute exacerbation of COPD complicated with respiratory failure.Methods From September 2013 to December 2016，86 patients with acute exacerbation of COPD complicated with respiratory failure were enrolled in this study.86 patients were randomly divided into two groups：two groups were given routine ventilator-assisted ventilation，and 42 patients in the control group were given the parenteral nutrition support after 24 hours mechanical ventilation，while 44 patients in the observation group were given the enteral nutrition，14 days were a course of treatment.The curative effect between two groups was compared.Results After treatment，the level of tumor necrosis factor （TNF-α） and interleukin-6 （IL-6） were decreased，and the value of CD4+，CD3+，CD4+/CD8+ were lower in the observation group，but the observation group was higher than the control group respectively （P0.05）.The incidence rate of double infection，liver function damage，gastrointestinal bleeding and blood sugar increase and mortality in the observation group were lower than those in the control group （P0.05）.Conclusion Early application of enteral nutrition in COPD patients with acute exacerbation of respiratory failure can promote disease rehabilitation，prevent immune function damage and reduce the incidence of complications，and it is worthy of population. 　　[Key words]