早期个体化序贯营养支持对老年慢性阻塞性肺疾病急性加重病人预后的影响

doi:10.3969/j.issn.1003-9198.2022.01.016

摘要/Abstract

摘要： 目的探讨早期个体化序贯营养支持对老年慢性阻塞性肺疾病急性加重(AECOPD)病人炎症反应、免疫功能、肺功能及营养状况的影响。方法选取我院2019年2月至2020年1月收治的老年AECOPD病人112例,根据随机数表分为序贯营养支持组(试验组,n=56)和常规营养支持组(对照组,n=56)。检测并比较2组病人治疗前后营养状况、肺功能、炎症指标、免疫指标和住院时间。结果治疗后,试验组病人营养状况指标BMI、营养评分(NRS2002)及血清前白蛋白、白蛋白、总蛋白水平较对照组均明显改善(P<0.05)。试验组肺功能指标FEV1/FVC、 FEV1% pred,炎症指标WBC、中性粒细胞绝对值、hs-CRP、TNF-α、IL-6,免疫功能指标CD3⁺、CD4⁺、CD4⁺/CD8⁺、淋巴细胞总数均较对照组明显好转(P<0.05)。试验组病人住院时间较对照组明显减少(P<0.05)。结论老年AECOPD病人早期开展个体化序贯营养支持有利于改善疾病预后,提高病人生存质量。

关键词: 慢性阻塞性肺疾病急性加重, 序贯营养支持, 老年人, 炎症反应, 肺功能, 免疫反应

Abstract: Objective To explore the effect of early sequential nutrition support on inflammation reaction, immune function, lung function and nutritional status in the elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods In this prospective randomized controlled trial, 112 AECOPD patients diagnosed in our hospital from February 2019 to January 2020 were divided into sequential enteral nutrition support group(experiment group, n=56) and conventional nutrition support group(control group, n=56). The nutrition index, lung function index, inflammatory index and immune index were measured and compared before and after treatment in the two groups. The hospitalization time of the two groups were compared. Results After treatment, the score of Nutrition Risk Screeing (NR S2002) and the levels of BMI, serum albumin, serum prealbumin, and total protein in the experiment group were improved significantly than those before treatment and those in the control group(P<0.05). The forced expiratory volume in 1 s/forced vital capacity(FEV1/FVC),FEV1% predicted(FEV1% pred)in the experimental group, and white blood cell(WBC), neutrophil count(N), high-sensitivity C-reactive protein(hs-CRP), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), immune function indexes (CD3⁺, CD4⁺, CD4⁺/CD8⁺, total lymphocyte count) were significantly improved than those in the control group (P<0.05). And the hospitalization time was significantly shorter than that of the control group (P<0.05). Conclusions For elderly patients with AECOPD, early individualized sequential nutritional support can help improve the prognosis and quality of life.

Key words: acute exacerbation of chronic obstructive pulmonary disease, sequential nutritional support, aged, inflammatory response, lung function, immune response

中图分类号:

R 563

王鹏, 王双, 李伟, 夏佳佳, 向勤. 早期个体化序贯营养支持对老年慢性阻塞性肺疾病急性加重病人预后的影响[J]. 实用老年医学, 2022, 36(1): 61-64.

WANG Peng, WANG Shuang, LI Wei, XIA Jia-jia, XIANG Qin. Effect of early sequential nutrition support on prognosis in elderly patients with acute exacerbation of chronic obstructive pulmonary disease[J]. Practical Geriatrics, 2022, 36(1): 61-64.

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