关键词：
老年;急性缺血性脑卒中;乳清蛋白;早期;肠内营养
摘 要：
目的:探讨老年急性缺血性脑卒中患者添加乳清蛋白早期肠内营养的效果。方法:将120例老年急性缺血性脑卒中患者按数字随机法分为观察组和对照组,每组患者60例。对照组采用常规治疗和肠内营养,观察组采用常规治疗和乳清蛋白强化的早期肠内营养,两组均治疗28d。比较两组营养状况、免疫功能、肺部感染、骨折等并发症发生情况和预后。结果:观察组治疗28d后体重、总蛋白、血红蛋白和白蛋白等营养学指标水平分别为59.45±22.25kg、72.05±7.42g/d L、16.02±2.75g/d L和41.15±3.68g/d L,均高于对照组的45.42±13.95kg、56.73±6.98g/d L、8.24±2.63g/d L和29.34±2.75g/d L,差异有统计学意义(P<0.05)。观察组治疗14d后Ig A、Ig G、Ig M等免疫球蛋白以及CD4+、CD4+/CD8+等T淋巴细胞及其亚群水平上升,对照组治疗21d后免疫球蛋白及其T淋巴细胞和其亚群水平出现升高,且治疗14d、21d以及28d后观察组免疫球蛋白及其T淋巴细胞和其亚群水平均高于对照组(P<0.05)。观察组肺部感染、骨折等并发症的总发生率为3.33%,显著低于对照组的11.67%(2=7.64,P<0.05)。观察组治疗后3个月、6个月和12个月的复发率和死亡率均显著低于对照组,差异有统计学意义(P<0.01)。结论:添加乳清蛋白早期肠内营养可明显改善老年急性缺血性脑卒中患者的营养状况和预后,提高患者的免疫功能水平并减少并发症的发生,值得临床推广应用。
译 名：
Application Value of Adding Whey Protein in Early Enteral Nutrition for Elderly Patients with Acute Ischemic Stroke
作 者：
HUANG Yu-ying;LU Man-fang;GU Xin;Deparement of Nutrition,the Third People's Hospital of Huizhou City;
关键词：
elderly;;acute ischemic stroke;;whey protein;;early;;enteral nutrition
摘 要：
Objective!!"To investigate the application value of adding whey protein in early enteral nutrition for elderly patients with acute ischemic stroke. !!!!"Method!!"Totally 120 elderly patients with acute ischemic stroke were divided into observation group and control group by Digital Random Method,60 cases for each group. Control group adopted conventional treatment and regular enteral nutrition while observation group adopted whey protein strengthened early enteral nutrition on the basis of control group. Two groups were treated for28 d. Nutritional status,immune function,pulmonary infection,fractures and other complications and prognosis of the 2 groups were compared. !!!!"Result!!"Weight,total protein,albumin and hemoglobin nutrition index level of observation group after 28 d treatment were 59. 45 ±22. 25 kg,72. 05 ± 7. 42 g / d L,16. 02 ± 2. 75 g / d L and 41. 15 ± 3. 68 g / d L respectively,which was higher than the 45. 42 ± 13. 95 kg,56. 73 ± 6. 98 g / d,8. 24 ± 2. 63 g / d L and 29. 34 ± 2. 75 g / d L of control group,and the difference was statistically significant( P < 0. 05).Immune globulin Ig A,Ig G,Ig M and T lymphocytes and their subsets CD4+,CD4+/ CD8+levels of control group after treatment for 14 d rose while immunoglobulin and T lymphocyte and its subsets level of control treatment rose after treatment for 21 d. Immunoglobulin and T lymphocyte and its subsets level of observation group was higher than that of the control group( P < 0. 05) after treatment for 14 d,21d and28 d. Total incidence of pulmonary infection,fracture and other complications was 3. 33%,which was significantly lower than the 11. 67%of control group( χ2= 7. 64,P < 0. 05). After treatment for 3 months,6 months and 12 months,recurrence rate and mortality rate of observation group were significantly lower than that of the control group,and the difference was statistically significant( P < 0. 01).!!!"Conclusion!!!"Adding whey protein in early enteral nutrition for elderly patients with acute ischemic stroke was worthy of clinical promotion use for it could obviously improve the nutritional status and prognosis and the patient's immune function and reduce complications.
