Chao Ke, Wang Dong, Yang Hongfu, Ma Ning, Liu Qilong, Sun Xiaoge, Sun Rongqing
Extracardiac Care Unit, Henan Provincial Chest Hospital, Zhengzhou, China.
Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Nutr. 2021 Aug 23;8:685422. doi: 10.3389/fnut.2021.685422. eCollection 2021.
Undernutrition is the main reason for the use of artificial nutrition in patients with severe neurological diseases. However, the clinical and immunological outcomes of enteral nutrition supplemented with immunomodulatory nutrients in these patients remain unclear. In this single-center, randomized controlled study, 57 patients with severe neurological diseases were randomly divided into the following two groups according to the type of enteral nutrition they would receive: immune-enhancing (IE) ( = 27) and non-IE (NIE) ( = 30). The IE and NIE groups received enteral nutrition supplemented with immunomodulatory nutrients and standard enteral nutrition, respectively. We compared the nutritional status and the state of cellular immunity between the patients of the two groups. Clinical and immunological variables were evaluated following nutritional treatment. Feeding intolerance was lower in the IE than that in the NIE group ( = 0.04). However, there were no significant differences between the results of the two groups in terms of length of stay in the intensive care unit or hospital, extubation time, or body mass index ( > 0.05). The CD4+ T-lymphocyte count and CD4/CD8+ ratio in the peripheral blood increased significantly in the IE group. The expression of CD28 activated cell surface markers was higher in the IE than in the NIE group. In addition, increased plasma interferon-γ levels were recorded in the IE group, whereas the levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-6, IL-8, and IL-10 decreased. Immune-enhanced enteral nutrition could improve the immune status and feeding tolerance in patients with severe neurological diseases. www.chictr.org.cn/index.aspx, identifier: ChiCTR-IPR-17013909.
营养不良是重症神经疾病患者使用人工营养的主要原因。然而，这些患者补充免疫调节营养素的肠内营养的临床和免疫结局仍不明确。在这项单中心随机对照研究中，57例重症神经疾病患者根据其将接受的肠内营养类型随机分为以下两组：免疫增强（IE）组（n = 27）和非免疫增强（NIE）组（n = 30）。IE组和NIE组分别接受补充免疫调节营养素的肠内营养和标准肠内营养。我们比较了两组患者的营养状况和细胞免疫状态。营养治疗后评估临床和免疫变量。IE组的喂养不耐受低于NIE组（P = 0.04）。然而，两组在重症监护病房或医院的住院时间、拔管时间或体重指数方面的结果无显著差异（P>0.05）。IE组外周血CD4 + T淋巴细胞计数和CD4/CD8 +比值显著增加。IE组CD28活化细胞表面标志物的表达高于NIE组。此外，IE组血浆干扰素-γ水平升高，而肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-6、IL-8和IL-10水平降低。免疫增强型肠内营养可改善重症神经疾病患者的免疫状态和喂养耐受性。www.chictr.org.cn/index.aspx，标识符：ChiCTR-IPR-17013909 。
