首页|不同肠内营养支持时机对脓毒症机械通气患者T淋巴细胞Th17/Treg比值及临床预后的影响

不同肠内营养支持时机对脓毒症机械通气患者T淋巴细胞Th17/Treg比值及临床预后的影响

扫码查看
目的:探讨不同肠内营养支持时机对脓毒症机械通气患者辅助性T细胞 17/调节性T淋巴细胞(Th17/Treg)比值及临床预后的影响.方法:选择九江学院附属医院 2022 年 8 月—2023 年 12 月收住ICU的 62 例确诊脓毒症行机械通气治疗的患者,随机分为早期组(n=31)及常规组(n=31).早期组则在入院 24 h内给予营养支持,常规组在入院 48~72 h给予营养支持.入院时及治疗 7 d后分别检测两组白介素-6(IL-6)、白介素-10(IL-10)、Th17、Treg水平,计算Th17/Treg比值,同时计算两组治疗前后急性生理与慢性健康评分(APACHEⅡ评分)及机械通气时间.结果:早期组治疗 7 d后IL-6、Th17水平、Th17/Treg比值均显著低于常规组(P<0.05),而治疗 7 d后两组IL-10 水平及Treg水平差异均无统计学意义(P>0.05);临床指标比较,治疗 7 d后,早期组白蛋白(ALB)及前蛋白(PA)水平均明显高于常规组,降钙素原(PCT)水平明显低于常规组,早期组机械通气时间短于常规组,APACHEⅡ评分明显低于常规组,差异均有统计学意义(P<0.05).结论:对于脓毒症机械通气患者血流动力学稳定情况下,早期给予适量肠内营养支持可以降低T淋巴细胞Th17/Treg比值,减轻脓毒症患者的炎症反应,提高患者的治疗效果.
Effect of Different Timing of Enteral Nutritional Support on T-lymphocyte Th17/Treg Ratio and Clinical Prognosis in Mechanically Ventilated Patients with Sepsis
Objective:To explore the effects of different timing of enteral nutritional support on T-lymphocyte Th17/Treg ratio and clinical prognosis in mechanically ventilated patients with sepsis.Method:Sixty-two patients admitted to the ICU of the Affiliated Hospital of Jiujiang College with a confirmed diagnosis of sepsis undergoing mechanical ventilation between August 2022 and December 2023 were selected and randomly divided into the early group(n=31)as well as the conventional group(n=31).In the early group,nutritional support was given within 24 h of admission,while in the conventional group,nutritional support was given within 48-72 h of admission.Interleukin(IL-6),interleukin(IL-10),Th17 and Treg levels were measured at admission and after 7 days of treatment,and the Th17/Treg ratio was calculated,as well as the acute physiology and chronic health score(APACHEⅡ score)before and after treatment and the duration of mechanical ventilation in the two groups.Result:After 7 days of treatment,the IL-6,Th17 level,Th17/Treg ratio of the early group were significantly lower than those of the conventional group(P<0.05),whereas there were no significant differences in the IL-10 level and the Treg level of the two groups after 7 days of treatment(P>0.05);for comparison of clinical indicators,after 7 days of treatment,the albumin(ALB)and preprotein(PA)levels of the early group were significantly higher than those of the conventional group,and the PCT level of the early group was significantly lower than that of the conventional group,the mechanical ventilation time of the early group was significantly shorter than that of the conventional group,and APACHEⅡ score of the early group was significantly lower than that of the conventional group,the differences were statistical significant(P<0.05).Conclusion:In the case of hemodynamic stabilization of mechanically ventilated patients with sepsis,early administration of appropriate amount of enteral nutritional support can reduce the T-lymphocyte Th17/Treg ratio,attenuate the inflammatory response of patients with sepsis,and improve the therapeutic efficacy of patients.

Early nutritional supportSepsisMechanical ventilationTh17/Treg ratio

杨蕙文、喻秋平、叶兴文、罗洋、刘松、赵鑫

展开 >

九江学院附属医院重症医学科 江西 九江 322000

早期营养支持 脓毒症 机械通气 Th17/Treg比值

江西省卫生健康委科技计划项目

202131100

2024

中国医学创新
中国保健协会

中国医学创新

影响因子:1.706
ISSN:1674-4985
年,卷(期):2024.21(19)
  • 2