Sun Jia-Kui, Yuan Shou-Tao, Mu Xin-Wei, Zhang Wen-Hao, Liu Ying, Zou Lei, Wang Xiang, Zheng Shu-Yun
Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China.
Medicine (Baltimore). 2017 Aug;96(32):e7702. doi: 10.1097/MD.0000000000007702.
The aim of this study was to investigate the effects of early enteral nutrition (EEN) on T helper lymphocytes and the subpopulations ratios of surgical septic patients.We performed a retrospective study including 107 eligible patients from February 2014 to December 2015. Patients were divided into EEN, delayed enteral nutrition (DEN), or total parenteral nutrition (TPN) group according to the duration before enteral feeding. Th1, Th2, Th17, and Treg lymphocyte percentages were collected on days 3, 7, and 14 after admission. The disease severity and clinical outcome variables were also recorded.The Th1, Th17 percentages, and Th1/Th2, Th17/Treg ratios of EEN group were significantly lower than those of DEN or TPN group on the 14th day after admission (P < .05). Compared with TPN, DEN might have a tendency to decrease the Th1 and Th17 percentages. EEN could improve the disease severity and clinical outcomes of septic patients, however, no difference on 28-day mortality was found between EEN and DEN group.EEN could improve the dysregulation of Th1/Th2 and Th17/Treg ratios during early stage of sepsis. Compared with DEN, EEN could improve the disease severity and clinical outcomes, but not decrease the 28-day mortality of surgical septic patients.
本研究旨在探讨早期肠内营养(EEN)对外科脓毒症患者辅助性T淋巴细胞及其亚群比例的影响。我们进行了一项回顾性研究,纳入了2014年2月至2015年12月期间107例符合条件的患者。根据肠内喂养前的持续时间,将患者分为EEN组、延迟肠内营养(DEN)组或全胃肠外营养(TPN)组。在入院后第3天、第7天和第14天收集Th1、Th2、Th17和调节性T细胞(Treg)淋巴细胞百分比。同时记录疾病严重程度和临床结局变量。入院后第14天,EEN组的Th1、Th17百分比以及Th1/Th2、Th17/Treg比值显著低于DEN组或TPN组(P<0.05)。与TPN相比,DEN可能有降低Th1和Th17百分比的趋势。EEN可改善脓毒症患者的疾病严重程度和临床结局,然而,EEN组和DEN组在28天死亡率方面未发现差异。EEN可改善脓毒症早期Th1/Th2和Th17/Treg比值的失调。与DEN相比,EEN可改善疾病严重程度和临床结局,但不能降低外科脓毒症患者的28天死亡率。