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倍氯米松和氨茶碱联合肠内营养对老年慢性阻塞性肺疾病患者营养状况和免疫功能的影响。

Effects of beclomethasone and aminophylline combined with enteral nutrition in chronic obstructive pulmonary disease on nutritional status and immune function in elders.

机构信息

Department of Geriatrics, Hunan Provincial People's Hospital, First Affiliated Hospital of Hunan Normal University, Hunan, China.

Department of Geriatrics, Hunan Provincial People's Hospital, First Affiliated Hospital of Hunan Normal University, Hunan, China. Email:

出版信息

Asia Pac J Clin Nutr. 2021;30(1):60-66. doi: 10.6133/apjcn.202103_30(1).0008.

Abstract

BACKGROUND AND OBJECTIVES

To investigate the efficacy of beclomethasone and aminophylline combined with enteral nutrition in the treatment of elderly patients with chronic obstructive pulmonary disease (COPD) and the associated effects of these drugs on patient nutritional status and immune function.

METHODS AND STUDY DESIGN

In total, 115 elderly patients with COPD were included and were randomized into an enteral nutrition (EN) group and a control (CON) group. Aminophylline, in combination with beclomethasone, was administered to the CON group, whereas aminophylline and beclomethasone in combination with EN was administered to the EN group.

RESULTS

Patients in the EN group showed significant improvement in partial pressure of carbon dioxide, forced expiratory volume in 1 sec/ expiratory forced vital capacity, and partial pressure of oxygen than those in the CON group. The levels of IgM, IgG, and IgA as well as the number of CD4+/CD8+ and CD4+/CD3+ T cells were higher in the EN group than those in the CON group (p<0.05); the EN group also exhibited higher levels of inflammatory cytokines, such as tumor necrosis factor-α and interleukin (IL)-1β (p<0.05), and lower levels of IL-6 than the CON group. In addition, patients in the EN group showed a significant increase in serum total protein, albumin, and transferrin levels than those in the CON group (p<0.05).

CONCLUSIONS

Elderly patients with COPD showed a marked response to a regimen of beclomethasone, aminophylline, and EN, which significantly improved their immune function and nutritional status.

摘要

背景与目的

探讨布地奈德和氨茶碱联合肠内营养治疗老年慢性阻塞性肺疾病(COPD)的疗效及对患者营养状态和免疫功能的影响。

方法和研究设计

共纳入 115 例老年 COPD 患者,随机分为肠内营养(EN)组和对照组(CON)。CON 组给予氨茶碱联合布地奈德治疗,EN 组给予氨茶碱联合布地奈德和 EN 治疗。

结果

EN 组患者的二氧化碳分压、1 秒用力呼气量/用力肺活量、氧分压较 CON 组明显改善。EN 组的 IgM、IgG 和 IgA 水平以及 CD4+/CD8+和 CD4+/CD3+T 细胞数量均高于 CON 组(p<0.05);EN 组肿瘤坏死因子-α和白细胞介素(IL)-1β等炎症因子水平也高于 CON 组(p<0.05),IL-6 水平低于 CON 组。此外,EN 组患者血清总蛋白、白蛋白和转铁蛋白水平明显高于 CON 组(p<0.05)。

结论

老年 COPD 患者对布地奈德、氨茶碱和 EN 联合治疗反应明显,显著改善了免疫功能和营养状态。

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