同种异体肾移植病人早期肠内免疫营养的临床疗效研究

发布时间：2018-05-16 01:22

本文选题：肠内营养 + 免疫营养　；参考：《肠外与肠内营养》2017年05期

【摘要】：目的 :研究对肾移植病人术后早期进行肠内免疫营养的有效性和安全性。方法 :将46例肾移植术后病人按营养方式随机分为肠内免疫营养组(实验组)和肠内普通营养组(对照组),分别进行免疫营养和普通营养,分别监测病人术前、术后第1天、第7天、第28天的免疫学指标:Ig G、Ig M、Ig A、CD3+淋巴细胞、CD4+淋巴细胞、CD8+淋巴细胞、CD4+/CD8+,同时监测相同时间点的营养学指标:白蛋白、前白蛋白、血红蛋白、胆固醇,比较两组的差异性。结果 :术后第1天,两组的免疫学指标无显著差异(P0.05);术后第7天,实验组的Ig M和Ig A均显著高于对照组(P0.05),两组的Ig G无明显差异(P0.05);实验组CD3+淋巴细胞较对照组有显著升高(P0.05),CD4+淋巴细胞、CD4+/CD8+两组间无显著性差异(P0.05);术后第28天,实验组Ig G、Ig M、Ig A、CD3+淋巴细胞、CD4+淋巴细胞、CD4+/CD 8+均显著高于对照组(P0.05)。两组的营养学指标,各个时间点均无显著性差异,但两组第28天的营养学指标除胆固醇外,均优于术后第1天,有显著性差异(P0.05)。术后30 d内,两组均未发生排异反应。结论 :肾移植病人术后早期应用肠内免疫营养在促进病人免疫功能恢复方面明显优于普通肠内营养,且不会增加排异反应发生。
[Abstract]:Objective: to study the efficacy and safety of enteral immune nutrition in early stage after renal transplantation. Methods: 46 patients after renal transplantation were randomly divided into enteral immune nutrition group (experimental group) and enteral common nutrition group (control group). On the 7th and 28th day, the immunological index of the CD4 / CD8 / CD8 / CD _ 4 / CD _ 8 / CD _ 4 / CD _ 8 / CD _ 4 / CD _ 8 / CD _ 4 / CD _ 8 / CD _ 4 / CD _ 8 / CD _ 4 / CD _ 8 / CD _ 4 / CD _ 8 / CD _ 4 / CD _ 8 / CD _ 4 / CD _ 8 / CD _ 4 / CD _ 8 lymphocytes were measured respectively. Results: on the first day after operation, there was no significant difference in immunological indexes between the two groups (P 0.05), but on the 7th day after operation, there was no significant difference between the two groups. The levels of IgM and IgA in the experimental group were significantly higher than those in the control group (P 0.05), and there was no significant difference between the two groups (P 0.05). The CD3 lymphocytes in the experimental group were significantly higher than those in the control group (P 0.05), and there was no significant difference in CD4 / CD8 ratio between the two groups (P 0.05), and on the 28th day after operation, there was no significant difference between the two groups. In the experimental group, the CD4 / CD _ 8 ratio of the CD4 / CD _ 4 / CD _ 4 / CD _ 4 / CD _ 4 / CD _ 4 / CD _ 8 ratio was significantly higher than that of the control group (P < 0.05). There was no significant difference in nutritional indexes between the two groups at all time points, but the nutritional indexes of the two groups on the 28th day, except cholesterol, were better than those on the first day after operation (P 0.05). Within 30 days after operation, no rejection reaction occurred in both groups. Conclusion: the early application of enteral immune nutrition in renal transplantation patients is superior to that of common enteral nutrition in promoting the recovery of immune function of patients and does not increase the incidence of rejection.
【作者单位】：宁波市医疗中心李惠利东部医院重症医学科;
【基金】：宁波市自然科学基金资助项目(NO.2012A610231、NO.2013A610235)
【分类号】：R459.3;R699.2

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