Effects of Nutritional Support on Blood Lipids,Inflammation and MACE in Elderly Patients with Coronary Heart Disease After Percutaneous Intervention
[Objective]To investigate the effects of perioperative enteral nutrition support on blood lipid,inflammatory response and the incidence of adverse cardiovascular events (MACE) in elderly patients with coronary heart disease after percutaneous coronary interven-tion (PCI).[Method]A total of 113 patients who underwent PCI in our hospital from December 2021 to May 2023 were selected for clinical study. Among them,57 patients received enteral nutrition support therapy based on glutamine during perioperative period (study group),and the other 56 patients received conventional dietary guidance mode during perioperative period (routine group). Myocardial enzymol-ogy,echocardiography,inflammatory response,blood lipid and other metabolic indicators after surgery were compared between the two groups,and the incidence of MACE events in patients with 1-year follow-up were compared.[Result]Before operation,there was no significant difference in serum CK-MB and cTnI between the study group and the conventional group (P>0.05). 48h after surgery,serum CK-MB and cTnI in 2 groups were significantly decreased (P<0.05),and there was no statistical significance between 2 groups (P>0.05). Before surgery,serum hs-CRP,IL-6,TNF-alpha and IL-10 between the study group and the conventional group had no statisti-cal significance (P>0.05). 48h after surgery,serum hs-CRP,IL-6,TNF-alpha and IL-10 in both groups were significantly decreased (P<0.05),and serum hs-CRP,IL-6 and TNF-alpha in the study group were lower than those in the conventional group (P<0.05). Before operation,there was no significant difference in serum TG,TC,LDL-C and HDL-C between the study group and the conventional group (P>0.05). One week after surgery,serum TG in both groups was significantly decreased (P<0.05),HDL-C in the study group was significantly increased compared with that before surgery (P<0.05). The serum HDL-C level of the study group was higher than that of the conventional group at 1 week after surgery (P<0.05). Before operation,there was no significant difference in LVEF,LAD,LVEDV and LVD between study group and conventional group (P>0.05). Three months after surgery,LVEDV and LVD in 2 groups were significantly decreased compared with before surgery (P<0.05),and LVEF and LAD in 2 groups were significantly increased compared with before surgery (P<0.05). The LVEF of the study group was higher than that of the conventional group,and the LVD of the study group was lower than that of the conventional group at 3 months after operation (P<0.05). After 1 year of follow-up,the incidence of MACE was 7.02％ in the study group and 16.07％ in the conventional group,with no statistical significance between the two groups (P>0.05).[Conclusion]In elderly patients with coronary heart disease PCI,enteral nutrition support therapy based on glutamine during perioperative period is beneficial to reduce the degree of inflammation,optimize the level of blood lipids,and is beneficial to postoperative cardiac function rehabilitation of patients,but has no significant effect on reducing the incidence of MACE events.
万方数据
维普
