摘要
目的探讨谷氨酰胺联合肠外营养支持对老年危重患者免疫功能及营养状况的影响。方法选取2018年3月至2019年8月本院收治的110例老年危重患者作为研究对象,随机分为对照组与观察组,每组55例。对照组单纯进行肠外营养支持,观察组在对照组基础上联合谷氨酰胺治疗,比较两组治疗前后免疫功能指标[免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)体液免疫指标及CD8^(+)、CD4^(+)、CD3^(+)细胞免疫指标]和营养状况[血清运铁蛋白(TF)、白蛋白(ALB)、氮平衡(NB)]。结果治疗前,两组IgG、IgA、IgM比较差异无统计学意义;治疗后,观察组IgG、IgA、IgM均显著优于对照组,差异有统计学意义(P<0.05)。治疗前,两组CD8^(+)、CD4^(+)、CD3^(+)比较差异无统计学意义;治疗后,观察组CD8^(+)、CD4^(+)、CD3^(+)均显著优于对照组,差异有统计学意义(P<0.05)。治疗前,两组TF、ALB、NB比较差异无统计学意义;治疗后,观察组TF、ALB、NB显著优于对照组,差异有统计学意义(P<0.05)。结论对老年危重患者进行谷氨酰胺与肠外营养支持联合治疗可显著改善患者免疫功能与营养状况,值得临床推广应用。
Objective To explore the effects of glutamine combined with parenteral nutrition support on immune function and nutritional status of elderly critically ill patients.Methods 110 elderly critically ill patients admitted to our hospital from March 2018 to August 2019 were selected as the research subjects,and they were randomly divided into control group and observation group,with 55 cases in each group.The control group received only parenteral nutrition support,and the observation group was treated with glutamine on the basis of the control group.The immune function indexes[immunoglobulin G(IgG),immunoglobulin A(IgA),immunoglobulin M(IgM)humoral immune indexes and CD8^(+),CD4^(+),CD3^(+)cellular immune indexes]and nutritional status[serum transferrin(TF),albumin(ALB),nitrogen balance(NB)]were compared between the two groups before and after teeatment.Results Before treatment,there was no significant difference in IgG,IgA,IgM between the two groups;after treatment,the IgG,IgA,IgM in observation group were significantly better than the control group,the difference was statistically significant(P<0.05).Before treatment,the difference in CD8^(+),CD4^(+),and CD3^(+)between the two groups was not statistically significant;after treatment,the CD8^(+),CD4^(+),and CD3^(+)of the observation group were significantly better than those of the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in TF,ALB,and NB between the two groups;after treatment,the TF,ALB,and NB of the observation group were significantly better than the control group,and the difference was statistically significant(P<0.05).Conclusion The combined treatment of glutamine and parenteral nutrition in elderly critically ill patients can significantly improve their immune function and nutritional status,and it is worthy of clinical application.
作者
刘喆吉
LIU Zheji(Department of Critical Medicine,the Second Affiliated Hospital of Shenyang Medical College,Shenyang,Liaoning,100002,China)
出处
《当代医学》
2021年第18期71-73,共3页
Contemporary Medicine
关键词
谷氨酰胺
肠外营养支持
老年危重患者
免疫功能
营养状况
Glutamine
Parenteral nutrition support
Elderly critically ill patients
Immune function
Nutritional status
