ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2021, Vol. 13 ›› Issue (5): 409-412.doi: 10.3969/j.issn.1674-3865.2021.05.011

• 临床研究 • 上一篇    下一篇

个体化营养支持管理下免疫肠内营养联合补充性肠外营养对重症病毒性脑炎患儿免疫功能及预后的影响

王春锋
  

  1. 461000 河南 许昌，许昌市妇幼保健院儿科
  • 收稿日期:2020-12-23 出版日期:2021-10-25 上线日期:2021-10-25
  • 通讯作者: 王春锋,E-mail：wangchunf0619@163.com

Effects of immune EN combined with SPN on immune function and prognosis of children with severe viral encephalitis under the management of individualized nutrition support

WANG Chunfeng   

  1. Xuchang Maternal and Child Healthcare Hospital, Xuchang 461000,China
  • Received:2020-12-23 Published:2021-10-25 Online:2021-10-25
  • Contact: WANG Chunfeng,E-mail：wangchunf0619@163.com

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摘要： 目的:分析个体化营养支持管理下免疫肠内营养联合补充性肠外营养对重症病毒性脑炎患儿免疫功能及预后的影响。方法:回顾性分析2015年8月至2019年8月在我院治疗的98例重症病毒性脑炎患儿临床资料，根据不同营养治疗方式将其分为观察组52例与对照组46例。观察组患儿实施个体化免疫肠内营养+补充性肠外营养治疗，对照组患儿使用常规肠内营养+补充性肠外营养治疗。比较治疗前后两组患儿营养状况（转铁蛋白、血红蛋白、血清白蛋白、前白蛋白）、免疫功能［免疫球蛋白（IgA、IgM、IgG）］、血清神经功能指标［神经元特异性烯醇化酶（NSE）、中枢神经特异性蛋白（S100β）］，随访6个月，统计后遗症（智力障碍、运动障碍、症状性癫痫）发生率。结果:治疗后，两组患儿转铁蛋白、血红蛋白、血清白蛋白、前白蛋白水平均高于治疗前，差异有统计学意义（P>0.05），但组间比较差异无统计学意义（P>0.05）。两组患儿治疗后IgA、IgM、IgG水平较治疗前显著升高，且观察组高于对照组，差异有统计学意义（P>0.05）；两组患儿治疗后NSE、S100β水平明显低于治疗前，差异有统计学意义（P>0.05），但组间比较差异无统计学意义（P>0.05）。随访6个月，两组患儿后遗症总发生率比较差异无统计学意义（P>0.05）。结论:个体化营养支持管理下免疫肠内营养联合补充性肠外营养可调节重症病毒性脑炎患儿免疫功能，改善预后。

关键词: 脑炎, 病毒性, 肠内营养, 补充性肠外营养, 免疫功能, 预后

Abstract: Objective:To analyze the effects of immune enteral nutrition(EN) combined with supplementary parenteral nutrition(SPN) on immune function and prognosis of children with severe viral encephalitis(SVE) under the management of individualized nutrition support.Methods:The clinical data of 98 SVE children treated in our hospital from August 2015 to August 2019 were retrospectively analyzed, and the patients were divided into observation group(n=52) and control group(n=46) according to different nutritional treatment methods. The patients in observation group were treated with individualized immune EN+SNP, and the children in control group were treated with routine EN+SNP. The nutritional status［transferrin(TRF), hemoglobin(Hb), serum albumin(ALB), prealbumin(PAB)］, immune function［immunoglobulins(IgA,IgM,IgG)］ and serum nerve function indicators［neuron-specific enolase(NSE), central nervous specific protein(S100β)］ were compared between the two groups before and after treatment. The children were given 6 months of follow-up, and the incidence rates of sequelae(mental retardation, dyskinesia, symptomatic epilepsy) were counted.Results:After treatment, the levels of TRF, Hb, ALB and PAB in the two groups were higher than those before treatment(P<0.05), but there were no statistically significant differences between the two groups(P>0.05). The levels of IgA, IgM, and IgG in the two groups were significantly higher than those before treatment, and the levels in observation group were higher than those in control group during the same period (P<0.05). The levels of NSE and S100β in the two groups were significantly lower than those before treatment(P<0.05), but there were no statistically significant differences between the two groups(P>0.05). At 6 months of follow-up, there was no statistical difference in the total incidence rate of sequelae between observation group and control group(P>0.05).Conclusion:EN combined with SPN under the management of individualized nutrition support can regulate the immune function and improve the prognosis of child patients with SVE.

Key words: Encephalitis, Viral, Enteral nutrition, Supplementary parenteral nutrition, Immune function, Prognosis