摘要
目的:分析肠内营养治疗对重症脑卒中患者炎症应激程度的影响及肠道菌群失调的影响因素.方法:选择自2022年1月至2023年5月收治的82例重症脑卒中患者,分为对照组和观察组,各41例.对照组予以常规治疗,观察组加用肠内营养治疗.比较两组治疗前后的炎症反应指标、应激反应指标、APACHEⅡ评分、GCS评分,使用因素分析发生肠道菌群失调的影响因素.结果:治疗后,与对照组比较:观察组C-反应蛋白(hs-CRP)、白介素-2(IL-2)、IL-6、肿瘤坏死因子-α(TNF-α)、去甲肾上腺素(NE)、皮质醇(COR)及APACHE Ⅱ评分表达水平低,对氧磷酶-1(PON-1)、谷胱甘肽过氧化(GSH-Px)、GCS评分高(P＜0.05);经因素分析,内毒素、高血压和糖尿病均是重症脑卒中患者发生肠道菌群失调的独立危险因素(P＜0.05).结论:肠内营养治疗能有效降低重症脑卒中患者的炎症应激程度,进而增加患者的临床获益,而患者发生肠道菌群失调与高血压、糖尿病和高水平内毒素有关.
Abstract
Objective:To analyze the effects of enteral nutrition on inflammatory stress and the influencing factors of intestinal flora disorder in patients with severe stroke.Methods:82 severe stroke patients admitted from January 2022 to May 2023 were divided into control group and observation group,41 each.The control group was treated with conventional treatment,and the observation group was treated with enteral nutrition.Compison of inflammatory response index,stress response index,APACHE Ⅱ score,and GCS score before and after treatment,and analyze factors influencing the occurrence of intestinal dysbiosis.Results:Post-treatment,compared with the matched group:C-reactive protein(hs-CRP),interleukin-2(IL-2),IL-6,tumor necrosis factor-α(TNF-α),noradrenaline(NE),cortisol(COR)and APACHE Ⅱ score,alpha-1,glutathione,GSH-1)(GSH-Px),GCS score(P＜0.05);by factor analysis,endotoxin,hypertension and diabetes were independent risk factors for intestinal dysfunction in severe stroke patients(P＜0.05).Conclusion:Enteral nutrition ther-apy can effectively reduce the degree of inflammatory stress in patients with severe stroke,and then increase the clinical benefit of patients,and the occurrence of intestinal flora imbalance in patients is related to hypertension,diabetes and high levels of endotoxin.
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