老年心力衰竭患者肠内营养与血清炎症因子及心功能的关系。
Relationship between enteral nutrition and serum levels of inflammatory factors and cardiac function in elderly patients with heart failure.
机构信息
Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
出版信息
Clin Interv Aging. 2018 Mar 7;13:397-401. doi: 10.2147/CIA.S157507. eCollection 2018.
OBJECTIVE
To investigate enteral nutrition's effect on serum inflammatory factors and the cardiac function of malnourished elderly patients with heart failure.
PATIENTS AND METHODS
A total of 105 elderly patients with heart failure were randomly divided into 3 groups: Treatment Group A, Treatment Group B, and the Control Group (Group C), each group having 35 patients and being administered conventional heart failure treatment. Group A was treated with 500 mL·d of enteral nutrition for 1 month. Group B was given the same dose of enteral nutrition for 3 months. The Control Group was given free diet. Nutritional risk screening 2002 was used to assess the nutritional status before and after the treatment for each group. New York Heart Association status was recorded as were left ventricular ejection fraction, plasma B-type natriuretic peptide, inteleukin-6, C-reactive protein, and tumor necrosis factor-α.
RESULTS
After the treatment, the body mass index, skinfold thickness of upper arm triceps, muscle circumference of the upper arm, upper arm muscle circumference, total protein, albumin, hemoglobin, and left ventricular ejection fraction in the treatment groups all increased, with relatively obvious relief of symptoms of heart failure. The levels of B-type natriuretic peptide, interleukin-6, tumor necrosis factor-α, and C-reactive protein all rose to different extents (<0.05) and Treatment Group B showed more obvious improvement (<0.01). Differences shown by the Control Group in each nutrition indicator, serum levels of inflammatory factors, and cardiac function had no statistical significance (>0.05).
CONCLUSION
The use of enteral nutrition in conventional treatment of elderly patients with heart failure could improve not only patients' nutritional status and cardiac function, but also their immune function, thus reducing the levels of inflammatory factors. The longer the treatment period is, the more obvious the improvement in patients' cardiac function and inflammatory factors will be observed.
目的
探讨肠内营养对老年心力衰竭伴营养不良患者血清炎症因子及心功能的影响。
方法
选取老年心力衰竭患者 105 例，随机分为 3 组：治疗组 A、治疗组 B 和对照组（C 组），每组 35 例，均给予常规心力衰竭治疗。A 组给予肠内营养 500mL·d-1，连用 1 个月；B 组给予肠内营养 500mL·d-1，连用 3 个月；C 组给予自由饮食。采用营养风险筛查 2002 对各组患者治疗前后的营养状况进行评估，记录纽约心功能分级、左心室射血分数，检测血浆 B 型利钠肽、白细胞介素-6、C 反应蛋白、肿瘤坏死因子-α。
结果
治疗后，各组患者的体质量指数、肱三头肌皮褶厚度、上臂中部肌围、上臂肌围、总蛋白、白蛋白、血红蛋白、左心室射血分数均升高，心力衰竭症状均有不同程度缓解。B 型利钠肽、白细胞介素-6、肿瘤坏死因子-α、C 反应蛋白水平均升高（<0.05），且治疗组 B 升高更为明显（<0.01）。对照组各项营养指标、血清炎症因子及心功能差异均无统计学意义（>0.05）。
结论
肠内营养支持治疗老年心力衰竭患者，不仅能改善患者的营养状态和心功能，还能改善患者的免疫功能，降低炎症因子水平，且治疗时间越长，患者心功能和炎症因子改善越明显。
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