肝硬化失代偿期病人辅助短肽型肠内营养制剂效果评价
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摘要
目的:评价短肽型肠内营养制剂辅助应用于肝硬化失代偿期人群的治疗效果,为肝硬化失代偿期病人的营养治疗提供依据。方法:选取100例肝硬化失代偿期病人,再将100名病人随机分为实验组和对照组,每组50人。两组均给予卧床休息,合理饮食,药物治疗等常规治疗措施;除此之外,实验组额外每日给予短肽型肠内营养制剂行辅助营养治疗,疗程两周。治疗前与治疗后检测临床指标,评价病人恢复情况。结果:治疗后实验组血红蛋白[(116.72±18.02)g/L vs (107.38±18.19)g/L]、白蛋白[(36.91±5.54)g/L vs (34.31±5.90)g/L]、前白蛋白[(116.02±55.56)mg/L vs (92.16±56.52)mg/L]显著高于对照组(P <0.05),而实验组空腹血糖相较于对照组下降[(5.15±1.03)mmol/L vs (6.2±2.8)mmol/L, P <0.05]。结论:肝硬化失代偿期病人辅助使用短肽型肠内营养制剂营养治疗可显著改善病人肝功能,营养状况及空腹血糖水平。
Objective: To evaluate the therapeutic effect of short peptide enteral nutrition supplements in patients with decompensated hepatocirrhosis. Methods: One hundred patients with decompensated cirrhosis were enrolled. The patients were randomised into experimental group and control group, with 50 patients in each group. Both groups were given routine treatments such as bed rest, reasonable diet, and drug treatment. In addition, the experimental group was administered an additional daily supplemental short-nutrient enteral nutrition for two weeks. Clinical indicators were obtained before and after treatment to evaluate the patient recovery. Results: After treatment, hemoglobin([116.72 ±18.02]g/L vs [107.38 ± 18.19]g/L), albumin([36.91±5.54]g/L vs [34.31±5.90]g/L) and prealbumin([116.02±55.56]mg/L vs [92.16±56.52]mg/L) in the experimental group were significantly higher than the control group(P <0.05). The fasting blood glucose([5.15±1.03]mmol/L vs [6.2±2.8]mmol/L) in the experimental group was significantly lower than that in the control group(P<0.05). Conclusion: The nutritional supplementation of short peptide enteral nutrition supplements in patients with decompensated cirrhosis can significantly improve liver function, nutritional status and fasting blood glucose levels.
Objective: To evaluate the therapeutic effect of short peptide enteral nutrition supplements in patients with decompensated hepatocirrhosis. Methods: One hundred patients with decompensated cirrhosis were enrolled. The patients were randomised into experimental group and control group, with 50 patients in each group. Both groups were given routine treatments such as bed rest, reasonable diet, and drug treatment. In addition, the experimental group was administered an additional daily supplemental short-nutrient enteral nutrition for two weeks. Clinical indicators were obtained before and after treatment to evaluate the patient recovery. Results: After treatment, hemoglobin([116.72 ±18.02]g/L vs [107.38 ± 18.19]g/L), albumin([36.91±5.54]g/L vs [34.31±5.90]g/L) and prealbumin([116.02±55.56]mg/L vs [92.16±56.52]mg/L) in the experimental group were significantly higher than the control group(P <0.05). The fasting blood glucose([5.15±1.03]mmol/L vs [6.2±2.8]mmol/L) in the experimental group was significantly lower than that in the control group(P<0.05). Conclusion: The nutritional supplementation of short peptide enteral nutrition supplements in patients with decompensated cirrhosis can significantly improve liver function, nutritional status and fasting blood glucose levels.
引文
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[12]Guo YJ, Tian ZB, Jiang N, et al. Effects of Late Evening Snack on Cirrhotic Patients:A Systematic Review and Meta-Analysis.Gastroenterol Res Pract.. 2018:9189062.
[13]于红卫,赵娟,王克菲,等.睡前加餐对不同Child-Pugh分级肝硬化患者能量代谢的影响研究.传染病信息, 2012,25(4):216-219.
[14]Hou W, Li J, Lu J, et al. Effect of a carbohydrate-containing lateevening snack on energy metabolism and fasting substrate utilization in adults with acute-on-chronic liver failure due to Hepatitis B. Eur J Clin Nutr. 2013(12):1251-1256.
[15]Nakaya Y, Okita K, Suzuki K, et al. BCAA-enriched snack improves nutritional state of cirrhosis. Nutrition, 2007, 23(2):113-120.
[16]Morihara D, Iwata K, Hanano T, et al. Late-evening snack with branched-chain amino acids improves liver function after radiofrequency ablation for hepatocellular carcinoma. Hepatol Res,2012,42(7):658-667.
[2]唐宏伟.早期应用短肽型肠内营养对上消化道出血患者营养指标的影响.河北联合大学学报(医学版), 2013(4):476-477.
[3]赵娜,任古松,张春霞.短肽型肠内营养制剂适用于老年脑卒中病人的营养支持.肠外与肠内营养, 2016, 23(1):34-36.
[4]舒晓亮,赵坚,刘载道,等.短肽型肠内营养对胃切除术后患者营养状态和肠道耐受性的影响.上海医学, 2015,38(3):235-238.
[5]Lala V, Minter DA. Liver Function Tests. StatPearls, 2008[Internet].
[6]姚芳芳,梅璐,何洁,等.副干酪乳杆菌N1115对肝硬化患者肠黏膜屏障功能的研究.中国微生态学杂志, 2017,29(7):750-753.
[7]罗育春,陈大兰.肝硬化患者血清谷丙转氨酶、谷草转氨酶和总胆红素与肝纤维化标志物的相关性研究.实用预防医学, 2011,18(8):1542-1544.
[8]殷张华,钱继红,朱天闻,等.短肽型肠内营养剂用于晚期早产儿疾病期营养支持前瞻性研究.中国实用儿科杂志, 2012,27(12):911-914.
[9]Ferreira LG, Anastácio LR, Lima AS, et al. Assessment of nutritional status of patients waiting for liver transplantation.ClinTranspl, 2011, 25(2):248-254.
[10]Henkel AS, Buchman AL. Nutritional support in patients with chronic liver disease. Nat Clin Pract Gastroenterol Hepatol, 2006,3(4):202-209.
[11]Plauth M, Merli M, Kondrup J, et al. ESPEN guidelines for nutrition in liver disease and transplantation. Clin Nutr, 1997, 16(2):43-55.
[12]Guo YJ, Tian ZB, Jiang N, et al. Effects of Late Evening Snack on Cirrhotic Patients:A Systematic Review and Meta-Analysis.Gastroenterol Res Pract.. 2018:9189062.
[13]于红卫,赵娟,王克菲,等.睡前加餐对不同Child-Pugh分级肝硬化患者能量代谢的影响研究.传染病信息, 2012,25(4):216-219.
[14]Hou W, Li J, Lu J, et al. Effect of a carbohydrate-containing lateevening snack on energy metabolism and fasting substrate utilization in adults with acute-on-chronic liver failure due to Hepatitis B. Eur J Clin Nutr. 2013(12):1251-1256.
[15]Nakaya Y, Okita K, Suzuki K, et al. BCAA-enriched snack improves nutritional state of cirrhosis. Nutrition, 2007, 23(2):113-120.
[16]Morihara D, Iwata K, Hanano T, et al. Late-evening snack with branched-chain amino acids improves liver function after radiofrequency ablation for hepatocellular carcinoma. Hepatol Res,2012,42(7):658-667.