摘要
目的 观察肠内免疫营养对多发伤患者免疫功能的影响.方法 上海长征医院综合性ICU 2007年3月至2008年5月收治32例多发伤患者,随机（随机数字法）分为肠内免疫营养组（EIN组,n=16）和普通配方肠内营养组（EN组,n=16）.两组患者于伤后第3天开始分别接受EIN和普通配方EN支持至少14 d.于入组当天、营养支持第7天和第14天分别检测外周血淋巴细胞计数（TLC）,免疫球蛋白（IgC,IgM,IgA）和T淋巴细胞亚群（CD3,CD4,CD8,CD4/CD8）.结果 EIN组第7天和第14天TLC,IgG,IgM,IgA,CD4及CD4/CD8比值均明显高于入组当天（P＜0.05）,且随EIN时间延长而持续增高;EN组所有免疫指标在第7天较入组当天无明显改变,第14天TLC,IgG,IgM,IgA,CD4及CD4/CD8比值均明显高于入组当天（P＜0.05）,但均明显低于EIN组第14天测定值（P＜0.05）.结论 与普通配方EN相比,多发伤后早期EIN更有利于机体体液和细胞免疫功能的恢复和提高.
Objective To study the effects of enteral immunonutrition on immune function in patients with multiple trauma. Method A total of 32 patients with multiple trauma admitted to general ICU in ChangZheng hospital, Shanghai from March 2007 to May 2008 were randomly （random number） divided into two groups,enteral immunonutrition group （EIN group, n = 16）and the general formula enteral nutrition group （EN group, n = 16）.Two groups of patients on the third day after injury began to accept the EIN and the general formula EN which respectively support at least 14 days. The patients peripheral blood lymphocyte count （TLC）, immunoglobulin （IgG,IgM, IgA） ,and T-lymphocyte subsets （CD3, CD4, CD8, CD4/CD8） were detected on the day of the group formation, the seventh and the fortteenth day of the nutritional support. Results TLC, IgG, IgM, IgA, CD4 and CD4/CD8 ratio were significantly higher in EIN Group on the 7th and 14th day than that on the first day （ P 〈0.05）, and extended with the EIN and sustained increase. All immunization indicators of EN group on the 7th day were no significant changes compared with the day of the group formation, and on the 14 th day TLC, IgG, IgM,IgA, CD4 and CD4/CD8 ratio were significantly higher than that on the day of the group formation （ P 〈 0.05）,but were significantly lower than that in the EIN group on the 14th day （ P 〈 0.05）. Conclusions Compared with the general formula EN, EIN is more helpful to restore and increase the humoral and cellular immune function in early post-multitraumatic phase.
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2010年第11期1197-1200,共4页
Chinese Journal of Emergency Medicine
关键词
多发伤
肠内免疫营养
免疫功能
Multiple trauma
Enteral immune nutrition
Immune function
