内科

目的探讨肠内营养支持对老年呼吸衰竭患者营养状态和免疫球蛋白及T细胞亚群的影响。方法选取2014年3月至2016年4月我院收治的经口进食不足的老年呼吸衰竭患者28例为研究对象，采用随机数字表法将患者随机分为观察组和对照组，每组14例。两组患者均予以抗感染、祛痰、解痉、平喘、面罩式无创正压通气等常规治疗，对照组患者在此基础上予以常规饮食指导，观察组患者在此基础上加用肠内营养支持治疗。观察两组患者治疗前后营养状态（白蛋白、血红蛋白、转铁蛋白和血清总蛋白）和免疫球蛋白（IgA、IgG、IgM）及T细胞亚群（CD3+、CD4+、CD8+、CD4+/CD8+）的变化情况。结果治疗前，两组患者营养状态、免疫球蛋白及T细胞亚群等指标比较差异无统计学意义（P＞0.05）。治疗7 d后，两组患者白蛋白、血红蛋白、转铁蛋白和血清总蛋白水平高于治疗前（P＜0.05）；IgA、IgG和IgM均高于治疗前（P＜0.05）；CD3+、CD4+和CD4+/CD8+均高于治疗前（P＜0.05），CD8+低于治疗前（P＜0.05），但两组上述各指标比较差异无统计学意义（P＞0.05）。治疗14 d后，两组患者上述指标均优于治疗7 d时（P＜0.05），且观察组患者各指标明显优于对照组（P＜0.05）。结论对于老年呼吸衰竭患者，在常规治疗的基础上予以肠内营养支持，能够有效改善患者营养状态，提高免疫功能。

ObjectiveTo investigate the effect of enteral nutrition support on nutritional status, immunoglobulins and T lymphocyte subgroups in elderly patients with respiratory failure. MethodsA total of 28 dietary deficiency elderly patients with respiratory failure treated in our hospital from March 2014 to April 2016 were selected and randomly assigned into observation group (n=14) and control group (n=14). Patients of the two groups were treated with conventional treatment, including anti-infection, asthma, expectorant, antispasmodic, noninvasive positive pressure ventilation, the patients in the control group received conventional diet guidance, while the patients in the observation group received enteral nutrition support on the basis of conventional diet guidance. The following parameters of two groups were observed before and after treatment: nutritional status (albumin, hemoglobin, transferrin and total serum protein), immunoglobulins (IgA, IgG, IgM), T lymphocyte subgroups (CD3+, CD4+, CD8+, CD4+/CD8+). ResultsBefore treatment, no statistical significance was found between two groups in nutritional status, immunoglobulins and T lymphocyte subgroups(P＞0.05). After 7 days of treatment, the levels of albumin, hemoglobin, transferrin and total serum protein, IgA, IgG and IgM, CD3+, CD4+ and CD4+/CD8+of the two groups were significantly increased compared to those before treatment(P＜0.05), and CD8+ of the two groups were significantly decreased compared to those before treatment (P＜0.05), but that was no significant difference of the above indexes was found between the two groups (P＞0.05). After 14 days of treatment, the above indexes of the two groups were significantly improved compared to those treatment for 7 days (P＜0.05), and the indexes of the observation group improved more significantly compared to those of the control group (P＜0.05). ConclusionsEnteral nutrition support combined with conventional treatment can effectively improve the nutritional status and immune function in elderly patients with respiratory failure.