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目的研究肠内营养支持对ICU患者免疫功能的影响。方法选取2009年1月～2011年1月某院ICU收治并进行肠内营养的16例患者为观察组研究对象,对比其接受肠内营养支持治疗前后细胞免疫和体液免疫的变化,另选取10例在该院体检中心查体的健康体检者作为对照。结果 (1)观察组患者肠内营养支持前CD4+淋巴细胞亚群水平(31.2±8.6)以及CD4+/CD8+比值(1.4±0.4)均低于正常对照组,比较差异有统计学意义(P﹤0.05);CD3+、CD8+T淋巴细胞亚群水平虽低于正常对照组,但比较差异无统计学意义(P﹥0.05);NK细胞水平略高于正常对照组,比较差异无统计学意义(P﹥0.05);IL2浓度(8.6±2.4)mg/L低于正常对照组,比较差异有统计学意义(P﹤0.05)。观察组患者肠内营养支持后CD3+、CD4+淋巴细胞亚群水平(76.5±13.7、49.2±12.4)以及CD4+/CD8+比值(2.9±0.9)高于治疗前和正常对照组,比较差异有统计学意义(P﹤0.05);CD8+T淋巴细胞亚群水平虽高于治疗前和正常对照组,但比较差异无统计学意义(P﹥0.05);NK细胞水平高于治疗前和正常对照组,比较差异无统计学意义(P﹥0.05);IL2浓度(12.2±3.9)mg/L高于支持前,比较差异有统计学意义(P﹤0.05);与正常对照组比较差异无统计学意义(P﹥0.05)。(2)观察组患者肠内营养支持前IgG、IgM、IgA浓度[(10.3±1.2)g/L、(1.2±0.6)g/L、(2.2±0.2)g/L]均低于正常对照组,比较差异有统计学意义(P﹤0.05)。观察组患者肠内营养支持后IgG、IgM、IgA浓度[(13.8±2.3)g/L、(2.1±0.4)g/L、(3.1±0.6)g/L)均高于支持前,比较差异有统计学意义(P﹤0.05);与正常对照组比较差异无统计学意义(P﹥0.05)。结论肠内营养支持可改善ICU危重症患者的细胞免疫和体液免疫功能。
Objective To study the effect of enteral nutrition on immune function in patients with ICU. Methods From January 2009 to January 2011, a hospital ICU admitted to enteral nutrition and 16 patients were observed in the study group, compared with their acceptance of enteral nutrition support before and after treatment of cellular and humoral immune changes, the other 10 Cases of physical examination in the hospital examination of the physical examination as a control. Results (1) The level of CD4 + lymphocyte subsets in pretreatment group was significantly lower than that in control group (31.2 ± 8.6) and CD4 + / CD8 + ratio (1.4 ± 0.4) ). The levels of CD3 +, CD8 + T lymphocyte subsets were lower than that of the normal control group, but the difference was not statistically significant (P> 0.05). The level of NK cells was slightly higher than that of the normal control group > 0.05). The concentration of IL2 was (8.6 ± 2.4) mg / L lower than that of the normal control group, the difference was statistically significant (P <0.05). The levels of CD3 +, CD4 + lymphocyte subsets (76.5 ± 13.7, 49.2 ± 12.4) and CD4 + / CD8 + ratio (2.9 ± 0.9) in the observation group after enteral nutrition support were significantly higher than those before treatment and the control group (P <0.05). Although the level of CD8 + T lymphocyte subsets was higher than that before treatment and normal control group, the difference was not statistically significant (P> 0.05); NK cell level was higher than that before treatment and normal control group There was no significant difference between the two groups (P> 0.05). IL2 concentration (12.2 ± 3.9) mg / L was higher than that before support (P <0.05) > 0.05). (2) The concentration of IgG, IgM and IgA in the observation group before enteral nutrition support were lower than those in the control group [(10.3 ± 1.2) g / L, (1.2 ± 0.6) g / L, Group, the difference was statistically significant (P <0.05). The concentrations of IgG, IgM and IgA in the patients in the observation group were significantly higher than those in the supportive group ([(13.8 ± 2.3) g / L, (2.1 ± 0.4) g / L, (P <0.05). Compared with the normal control group, there was no significant difference (P> 0.05). Conclusion Enteral nutrition support can improve the cellular immunity and humoral immune function in critically ill ICU patients.