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目的探讨肠外营养(PN)支持对慢性阻塞性肺疾病急性加重期(AECOPD)患者治疗的影响。方法 AECOPD患者80例,随机均分为PN组及对照组,给予为期2周包括PN的综合治疗。结果 PN组有效率90%,高于对照组的65%(P<0.05)。对照组除血总淋巴细胞计数(TLC)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)显著改善外(P<0.05),其他参数均无显著变化。PN组除CD8及IgM、IgG变化不大,其他指标如实际体重与标准体重百分比(IBW%)、肱三头肌皮褶厚度(TSF)、上臂肌围(MAMC)、血清白蛋白(ALB)、TLC、CD3、CD4、CD4/CD8、IgA、用力肺活量(FVC)、1秒用力呼气容积占用肺活量比(FEV1/FVC)及PaO2、PaCO2均有明显改善(P<0.05)。结论包括PN的合理营养支持治疗可改善AECOPD患者的免疫功能和肺功能,提高临床疗效。
Objective To investigate the effect of parenteral nutrition (PN) support on the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods 80 patients with AECOPD were randomly divided into PN group and control group, giving a comprehensive treatment of 2 weeks including PN. Results The PN group was 90% efficient, which was higher than 65% of the control group (P <0.05). In the control group, TLC, PaO 2 and PaCO 2 were significantly improved (P <0.05), while other parameters had no significant changes. In addition to CD8 and IgM in PN group, IgG did not change much. Other indexes such as IBW, TSF, MAMC, ALB, , TLC, CD3, CD4, CD4 / CD8, IgA, forced vital capacity (FVC), FEV1 / FVC and PaO2 and PaCO2 in all patients were significantly improved (P <0.05). Conclusions The rational nutrition supportive therapy including PN can improve the immune function and lung function of AECOPD patients and improve the clinical curative effect.