不同肠内营养制剂对脓毒症肠黏膜屏障及Toll样受体9信号通路的影响
Effects of enteral nutrition preparations on intestinal mucosal barrier and Toll-like receptor 9 signaling pathways of sepsis patients
王敏娜 1郭君 1徐翠翠 1孙婧婧 1张蕾1
作者信息
- 1. 西安交通大学第一附属医院重症医学科,陕西西安 710061
- 折叠
摘要
目的 分析不同肠内营养制剂对脓毒症患者肠黏膜屏障及Toll样受体9(TLR9)信号通路的影响.方法 选取2020年3月-2023年3月西安交通大学第一附属医院收治的脓毒症患者128例为研究对象,随机数字表法分为A组与B组,各64例.A组予以TP型肠内营养乳剂治疗,B组予以TPF-D型肠内营养乳剂治疗,两组均治疗7d.比较两组病情进展,治疗前、治疗7 d后肠黏膜屏障、TLR9信号通路、免疫功能、营养水平.结果 B组机械通气时间、重症监护病房(ICU)住院时间、总住院时间短于A组(P＜0.05).与治疗前比较,治疗7 d后两组血清D-乳酸(D-lac)、二胺氧化酶(DAO)、内毒素(ET)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、TLR9、核因子κB(NF-κB)水平,全血CD8+水平降低,且B组更低(P＜0.05).与治疗前比较,治疗7 d后两组全血CD4+、CD4+/CD8+水平,血清白蛋白(PA)、转铁蛋白(TF)、血红蛋白(Hb)水平升高,且B组更高(P＜0.05).结论 TPF-D型肠内营养制剂可促进脓毒症的病情恢复,降低肠黏膜屏障损伤,调节TLR9信号通路介导的机体炎症反应,提高机体免疫功能及营养水平.
Abstract
OBJECTIVE To observe the effects of enteral nutrition preparations on intestinal mucosal barrier and Toll-like receptor 9(TLR9)signaling pathways of the sepsis patients.METHODS A total of 128 patients with sep-sis who were treated in the First Affiliated Hospital of Xi'an Jiaotong University from Mar 2020 to Mar 2023 were recruited as the research subjects and were randomly divided into the group A and the group B,with 64 cases in each group.The group A was treated with TP type enteral nutrition emulsion,and the group B was treated with TPF-D enteral nutrition emulsion,and both groups were treated for 7 days.The progression of illness condition was compared between the two groups;the intestinal mucosal barrier,TLR9 signaling pathways,immune func-tion and nutrition level were observed and compared between the two groups before the treatment and after the treatment for 7 days.RESULTS The mechanical ventilation duration,length of intensive care unit(ICU)stay and total length of hospital stay were shorter in the group B than in the group A(P＜0.05).The levels of serum D-lactic acid(D-lac),diamine oxidase(DAO),endotoxin(ET),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),TLR9 and nuclear factor-κB(NF-κB)of the two groups were lower after the treatment for 7 days than before the treatment,the whole blood CD8+level was lower after the treatment for 7 days than before the treat-ment,the levels of above indexes of the group B were lower than those of the group A(P＜0.05).The levels of whole blood CD4+,CD4+/CD8+,serum albumin(ALB),transferrin(TF)and hemoglobin(Hb)were higher af-ter the treatment for 7 days than before the treatment,and the levels of above indexes of the group B were higher than those of the group A(P＜0.05).CONCLUSION The TPF-D type enteral nutrition emulsion may promote the recovery of sepsis condition,reduce the damage of intestinal mucosal barrier,regulate the TLR9 signaling path-way-mediated inflammatory response and improve the immune function as well as the nutrition level.
关键词
脓毒症/肠内营养制剂/肠黏膜屏障/Toll样受体9/免疫功能/营养水平/TP型肠内营养乳剂/TPF-D型肠内营养乳剂Key words
Sepsis/Enteral nutrition preparation/Intestinal mucosal barrier/Toll-like receptor 9/Immune func-tion/Nutrition level/TP type enteral nutrition emulsion/TPF-D type enteral nutrition emulsion引用本文复制引用
基金项目
陕西省自然科学基础研究计划基金资助项目(2018JM7021)
出版年
2024
NETL
NSTL
万方数据