張蕾

[摘要]目的 探討早期腸內(nèi)營養(yǎng)對(duì)急性重癥胰腺炎炎性狀況、細(xì)胞免疫功能及營養(yǎng)狀況的影響。方法 選擇2015年10月～2017年11月本院收治的80例急性重癥胰腺炎患者作為研究對(duì)象，按照隨機(jī)數(shù)字表法分為觀察組與對(duì)照組，每組各40例。觀察組患者實(shí)施早期腸內(nèi)營養(yǎng)，對(duì)照組患者給予完全胃腸外營養(yǎng)，比較兩組患者干預(yù)后的血清蛋白（如轉(zhuǎn)鐵蛋白、前白蛋白及白蛋白水平）變化情況，統(tǒng)計(jì)兩組干預(yù)后的炎癥性細(xì)胞因子[腫瘤壞死因子-α（TNF-α），超敏C反應(yīng)蛋白（hs-CRP）及白細(xì)胞介素-6（IL-6）]水平變化情況及兩組干預(yù)后的細(xì)胞免疫CD4+、CD8+及CD4+/CD8+水平變化情況。結(jié)果 觀察組干預(yù)后的轉(zhuǎn)鐵蛋白、前白蛋白及白蛋白水平均顯著高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組干預(yù)后的TNF-α、hs-CRP及IL-6水平均低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組干預(yù)后的CD4+、CD8+水平均高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組干預(yù)后的CD4+/CD8+比值大于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 針對(duì)急性胰腺炎患者，實(shí)施早期腸內(nèi)營養(yǎng)支持能顯著改善患者營養(yǎng)狀況，減輕炎性反應(yīng)，提高機(jī)體免疫力。

[關(guān)鍵詞]早期；腸內(nèi)營養(yǎng)；急性重癥胰腺炎；炎性狀況；細(xì)胞免疫功能；營養(yǎng)狀況

[中圖分類號(hào)] R576 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-4721（2019）4（c）-0076-03

Influence of early enteral nutrition on inflammatory status， cellular immune function and nutritional status of acute severe pancreatitis

ZHANG Lei

EICU， Affiliated Zhongshan Hospital of Dalian University in Liaoning Province， Dalian 116001， China

[Abstract] Objective To investigate the influence of early enteral nutrition on inflammatory status， cellular immune function and nutritional status of acute severe pancreatitis. Methods A total of 80 cases with acute severe pancreatitis admitted in our hospital from October 2015 to November 2017 were selected as research objects and divided into the observation group and the control group according to the random number table method， 40 cases in each group. The observation group was given early enteral nutrition， and the control group was given complete parenteral nutrition. The changes of serum proteins such as transferrin， prealbumin and albumin after intervention were compared between the two groups. The levels of inflammatory cytokines such as tumor necrosis factor-α （TNF-α）， hypersensitive C-reactive protein （hs-CRP） and interleukin-6 （IL-6） after intervention and the levels of CD4+， CD8+ and CD4+/CD8+ after intervention were counted. Results After intervention， the levels of transferrin， prealbumin and albumin in the observation group were significantly higher than those in the control group， and the differences were statistically significant （P<0.05）. The levels of TNF-α， hs-CRP and IL-6 in the observation group after intervention were significantly higher than those in the control group， and the differences were statistically significant （P<0.05）. The levels of CD4+ and CD8+ in the observation group after intervention were significantly higher than those in the control group， and the differences were statistically significant （P<0.05）. The ratio of CD4+/CD8+ in the observation group after intervention was greater than that in the control group， and the difference was statistically significant （P<0.05）. Conclusion For patients with acute pancreatitis， early enteral nutrition support can improve the nutritional status and reduce inflammation and improve immunity.