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目的:研究疫肠内营养对于慢阻肺合并Ⅱ型呼吸衰竭患者免疫恢复情况的影响。方法:选取2011年6月-2013年1月在我院进行住院治疗的90例慢阻肺合并Ⅱ型呼吸衰竭患者,按随机分组原则将其分为实验组和对照组,实验组患者给予免疫肠内营养支持治疗,对照组患者进行常规肠内营养支持,分别在方案实施前、实施后2天、9天测量患者血浆蛋白(前白蛋白、白蛋白、转铁蛋白),外周血淋巴细胞亚群(CD3+,CD8+,CD4+/CD8+)、血清免疫球蛋白(IgA,IgG,IgM)、IL-2和IL-6的浓度水平,通过实验组、对照组、正常值之间的比较进行效果评价。结果:两组患者在进行营养支持疗法前,以上数值无明显差异,实施后第2天,两组患者血浆蛋白含量、血淋巴细胞亚群(CD3+,CD4+/CD8+)、血清免疫球蛋白(IgA,IgG,IgM)、IL-2的浓度明显提升,但实验组患者的免疫相关数值和对照组无明显差异,P>0.05,差异无统计学意义;第9天时,两组患者,两组患者外周血淋巴细胞亚群(CD3+,CD4+/CD8+)、血清免疫球蛋白(IgA,IgG,IgM)、IL-2在明显提升的基础上,实验组明显高于对照组,但仍低于正常值,P<0.05,差异有统计学意义。但CD8+、IL-6出现明显下降,实验组明显低于对照组,P<0.05,差异有统计学意义。结论:免疫肠内营养能够有效改善机体营养状态,增强机体免疫功能,促进患者恢复,建议在临床上推广应用。
Objective: To study the effect of enteral nutrition on immune recovery in patients with chronic obstructive pulmonary disease and type Ⅱ respiratory failure. Methods: Ninety patients with chronic obstructive pulmonary disease and type Ⅱ respiratory failure hospitalized in our hospital from June 2011 to January 2013 were divided into experimental group and control group according to the principle of randomization. Patients in experimental group were given immunization Enteral nutrition supportive therapy and control group patients were enrolled in routine enteral nutrition support. Plasma protein (prealbumin, albumin, transferrin), peripheral blood lymphocytes The level of serum immunoglobulin (IgA, IgG, IgM), IL-2 and IL-6 in subgroups (CD3 +, CD8 +, CD4 + / CD8 +) were compared between the experimental group, control group and normal group Evaluation. Results: Before the nutritional support therapy, there was no significant difference between the two groups. On the second day after the operation, the plasma protein contents, blood lymphocyte subsets (CD3 +, CD4 + / CD8 +), serum IgA , IgG, IgM), IL-2 concentration increased significantly, but the experimental group of patients with immune-related values and the control group no significant difference, P> 0.05, the difference was not statistically significant; on the 9th day, two groups of patients, two groups of patients The levels of peripheral blood lymphocyte subsets (CD3 +, CD4 + / CD8 +), serum immunoglobulin (IgA, IgG, IgM) and IL-2 were significantly higher in the experimental group than those in the control group , P <0.05, the difference was statistically significant. However, the levels of CD8 + and IL-6 in the experimental group were significantly lower than those in the control group (P <0.05). The difference was statistically significant. Conclusion: Enteral nutrition can effectively improve the nutritional status of the body, enhance the immune function, and promote the recovery of patients. It is suggested that it should be widely applied in clinic.