口服营养补充对老年慢性病伴营养不良人群营养指标及免疫功能的影响

朱永飞 刘娜 姚飞 刘伟

【摘要】 目的 探究口服营养补充对老年慢性病伴营养不良人群营养指标以及免疫功能的影响。方法 选取于2018年9月至2019年9月诊治的老年慢性病伴营养不良住院患者100例，采用随机数字表将其分为对照组和观察组，各50例。对照组给予普食干预，观察组在对照组基础上给予口服营养补充干预，两组均干预3个月。比较两组患者干预前后营养指标、免疫功能指标以及胃肠黏膜屏障功能相关指标的差异性，并评价安全性。结果 两组患者的体重指数（BMI）、三头肌皮褶厚度（TSF）以及血红蛋白（Hb）干预前后均无统计学意义（P>0.05），观察组干预后的上臂围（MAC）、白蛋白（ALB）、前白蛋白（PAB）均显著高于对照组（P<0.01）。观察组干预后的CD3+、CD4+以及CD4+/CD8+较干预前明显升高（P<0.05），且均显著高于对照组（P<0.01）。两组干预后的二胺氧化酶（DAO）及尿L/M值均明显低于干预前（P<0.01），且观察组干预后的DAO以及尿L/M值均显著低于对照组（P<0.05）。两组不良反应发生率分别为8.00%和12.00%，差异无统计学意义（P>0.05）。结论 老年慢性病伴營养不良人群给予口服营养补充，有助于改善患者机体营养状况，提高机体免疫功能和肠黏膜屏障功能，安全系数较高。

【关键词】 口服营养补充;慢性病;营养不良;老年;营养指标;免疫功能

中图分类号：R459.3 文献标志码：A DOI：10.3969/j.issn.1003-1383.2021.01.013

【Abstract】 Objective To explore the effects of oral nutritional supplementation on nutrition indexes and immune function of elderly patients with chronic diseases and malnutrition.Methods A total of 100 elderly inpatients with chronic diseases and malnutrition who were diagnosed and treated in the hospital from September 2018 to September 2019 were enrolled. They were divided into control group and observation group by random number table， with 50 cases in each group. The control group were given general diets intervention， and based on which the observation group were given oral nutrition supplement intervention. Both groups were intervened for 3 months. And then， differences in nutrition indexes， immune function indexes and related indexes of gastrointestinal mucosal barrier function before and after intervention were compared between two groups， and the safety was evaluated.Results Before and after intervention， there was no statistically significant differences in body mass index （BMI）， triceps skin fold （TSF） and hemoglobin （Hb） between the two groups （P > 0.05）. After intervention， mid-arm circumference （MAC）， albumin （ALB） and prealbumin （PAB） in the observation group were all significantly higher than those in the control group （P < 0.01）. After intervention， CD3+， CD4+ and CD4+/CD8+ were significantly increased in observation group （P < 0.05）， which were significantly higher than those in the control group （P < 0.01）. After intervention， diamine oxidase （DAO） and urine L/M in both groups were significantly decreased （P < 0.05）， which were significantly lower in the observation group than in the control group （P < 0.01）. The incidence of adverse reactions in the two groups was 8.00% and 12.00%， respectively， difference was not statistically significant （P > 0.05）.Conclusion Oral nutritional supplements for the elderly with chronic diseases and malnutrition are conductive to improving nutrition status， immune functions and intestinal mucosal barrier functions with high safety factor.

【Key words】 oral nutritional supplement; chronic disease; malnutrition; the elderly; nutrition index; immune function

随着老年人口的持续上升，慢性非传染性疾病已成为世界范围内一个重要的公共问题[1]，80%的慢性病死亡发生在低收入和中等收入国家[2]。慢性病的高发与膳食结构不合理、缺乏体力活动、吸烟酗酒等不良生活习惯密切相关[3]。营养不良是老年慢性病患者高病死率的重要因素之一[4]。我国60岁以上的老年人发生营养不良的概率为5.4%[5]。鉴于老年群体的特殊性，该类人群通常合并多种疾病，病情繁杂，因此，其营养支持至关重要。本研究对老年慢性病伴营养不良患者行口服营养补充干预，旨在探究此种干预方式对患者营养指标、免疫功能指标的影响。