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目的:研究早期免疫型肠内营养联合谷氨酰胺(Gln)肠外营养对重症加强护理病房(ICU)重症肺部感染患者T淋巴细胞亚群的影响。方法:选取2017年1月至2019年10月在浙江省宁波市鄞州人民医院接受诊治的ICU重症肺部感染患者70例,按照完全随机数字表法将患者分为肠内营养组、联合组,各35例。两组患者均给予常规治疗;肠内营养组在常规治疗的基础上给予免疫增强型肠内营养;联合组在肠内营养组的基础上给予Gln。检测两组治疗前后动脉血氧分压(PaOn 2)、动脉血氧饱和度(SaOn 2)、动脉血二氧化碳分压(PaCOn 2)、CDn 8+、CDn 3+、CDn 4+/CDn 8+、降钙素原(PCT)、超敏C反应蛋白(hs-CRP)及肿瘤坏死因子-α(TNF-α)水平的变化,并比较两组的疗效。n 结果:联合组治疗后SaOn 2、PaOn 2水平高于肠内营养组,PaCOn 2水平低于肠内营养组,但差异无统计学意义(n P>0.05)。联合组治疗后CDn 3+、CDn 4+/CDn 8+水平高于肠内营养组[(62.37 ± 6.15)%比(59.35 ± 5.24)%、1.50 ± 0.18比1.12 ± 0.11],CDn 8+水平低于肠内营养组[(33.15 ± 6.11)%比(37.72 ± 8.57)%],差异有统计学意义(n P<0.05)。联合组治疗后PCT、hs-CRP及TNF-α水平低于肠内营养组[(3.83 ± 0.82)μg/L比(6.47 ± 1.34)μg/L、(6.92 ± 1.25)mg/L比(12.72 ± 3.83)mg/L,(92.35 ± 13.05)ng/L比(125.26 ± 18.35)ng/L],差异有统计学意义(n P<0.05)。联合组治疗后总有效率高于肠内营养组[88.57%(31/35)比65.71%(23/35)],差异有统计学意义(n χn 2=5.185,n P0.05). After treatment, the levels of CDn 3+, CDn 4+/CDn 8+ in combined group were higher than those in enteral nutrition group [(62.37 ± 6.15)% vs. (59.35 ± 5.24)%, 1.50 ± 0.18 vs. 1.12 ± 0.11], the level of CDn 8+ in combined group was lower than that in enteral nutrition group [(33.15 ± 6.11)% vs. (37.72 ± 8.57)%], and there were significant differences (n P<0.05). The levels of PCT, hs-CRP and TNF-αin combined group were lower than those in enteral nutrition group [(3.83 ± 0.82) μg/L vs. (6.47 ± 1.34) μg/L, (6.92 ± 1.25) mg/L vs. (12.72 ± 3.83) mg/L, (92.35 ± 13.05) ng/L vs. (125.26 ± 18.35) ng/L], and there were significant differences (n P<0.05). The total effective rate in combined group was higher than that in enteral nutrition group [88.57%(31/35) vs. 65.71%(23/35)], and there was significant difference (n χ2=5.185, n P<0.05).n Conclusions:Early immune enteral nutrition combined with Gln parenteral nutrition has significant effects on patients with severe pulmonary infection in ICU, and can improve the level of T-lymphocyte subsets, control infection, and reduce inflammatory factor levels.