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目的观察应用强化谷氨酰胺的肠内营养对严重颅脑损伤患者应激和免疫状态的影响。方法72例严重脑损伤患者随机分为实验组和常规组,每组36例,放置鼻-十二指肠管,均使用肠内营养支持泵均匀持续滴注的鼻饲方法,实验组使用肠内营养制剂强化谷氨酰胺,常规组使用肠内营养制剂加蛋白粉,两者氨热比值保持一致。2周后抽静脉血,观察两组患者实验前后的应激状态[C3、C4、C反应蛋白(CRP)]和免疫功能(CD4+、CD8+、CD4+/CD8+I、gAI、gGI、gM)的变化。结果实验结束时实验组C3、C4、CRP低于实验前,实验组C3、C4、CRP含量均低于常规组,差异有统计学意义。实验结束时实验组CD4+、CD4+/CD8+I、gAI、gG均高于实验前,差异有统计学意义,CD4+、CD4+/CD8+I、gAI、gG均高于常规组,差异有统计学意义,两组的CD8+数量的差异无统计学意义(P>0.05)。结论强化谷氨酰胺的肠内营养能有效地改善严重脑损伤患者的应激和免疫状态。
Objective To observe the effect of enteral nutrition with fortified glutamine on stress and immune status in patients with severe craniocerebral injury. Methods Seventy-two patients with severe brain injury were randomly divided into experimental group and conventional group, with 36 patients in each group. Nasal-duodenal tubes were placed in the nasal-duodenal ducts. Enteral nutrition support pump Formulation fortified glutamine, conventional group using enteral nutrition plus protein powder, the ammonia heat ratio between the two consistent. Venous blood was taken two weeks later and the stress state [C3, C4, C-reactive protein (CRP)] and immune function (CD4 +, CD8 +, CD4 + / CD8 + I, gAI, gGI, gM) Variety. Results At the end of the experiment, the levels of C3, C4 and CRP in the experimental group were lower than those before the experiment, and the contents of C3, C4 and CRP in the experimental group were lower than those in the conventional group. The difference was statistically significant. At the end of the experiment, the levels of CD4 +, CD4 + / CD8 + I, gAI, gG in the experimental group were significantly higher than those before the experiment, and the difference was statistically significant, the levels of CD4 +, CD4 + / CD8 + There was no significant difference in the number of CD8 + between the two groups (P> 0.05). Conclusions Fortified glutamine enteral nutrition can effectively improve the stress and immune status of patients with severe brain injury.