强化精氨酸肠内营养对重症脑卒中患者营养状态及预后的影响

    The effect of enriched arginine in enteral nutrition on the nutritional status and prognosis of patients with severe stroke

    • 摘要: 目的:探讨精氨酸对重症脑卒中患者急性期营养状况及卒中后神经功能康复的影响。方法:采用前瞻性对照研究,将80例重症脑卒中患者按随机数字表法分为强化精氨酸肠内营养组(强化组)和普通肠内营养组(普通组),于营养治疗前和营养治疗后的第10天、第20天分别检测白蛋白(ALB)、前白蛋白(PA)、三酰甘油(TG)、总胆固醇(TC)和淋巴细胞总数(TLC)。并对神经功能进行美国国立卫生研究院卒中量表(NIHSS)评分。结果:2组患者在营养治疗前,营养指标及NIHSS评分差异均无统计学意义(P0.05);治疗后第20天,强化组的血清ALB、PA和TLC均显著高于普通组(P0.01)。强化组患者治疗后第10天和第20天PA及TLC均较治疗前有所下降,但差异均无统计学意义(P0.05);而普通组的ALB、PA水平和TLC均较治疗前下降(P0.05~P0.01);治疗后第10天和第20天普通组和强化组患者的NIHSS评分均较治疗前下降(P0.01),在营养治疗后第10天2组患者的NIHSS评分差异无统计学意义(P0.05),而在第20天强化组的评分比普通组更低(P<0.01)。结论:精氨酸能够明显改善重症脑卒中患者的营养状况,促进患者神经功能康复。

       

      Abstract: Objective:To explore the effects of arginine on the nutritional status at acute episode and neurological rehabilitation of patients with severe stroke.Methods:Eighty patients with severe stroke were randomly divided into enriched arginine enteral nutrition group(intensive group) and normal enteral nutrition group(normal group) by the prospective controlled method.The levels of albumin(ALB),prealbumin(PA),triglycerides(TG) and total cholesterol(TC),total lymphocyte count(TLC) and NIH stroke scale(NIHSS) scores of nerve function in two groups were investigated before nutritional therapy and at 10 and 20 d after treatment.Results:The differences of nutritional indexes and NIHSS scores in two group before nutritional therapy were not statistical significance(P0.05),the levels of ALB,PA and TLC in intensive group were significantly higher than those in normal group at 20 d after treatment(P0.01).Compared with before treatment,the level of PA and TLC in intensive group decreased,the difference of which had no statistical significance(P0.05).Compared with before treatment,the levels of ALB and PA and TLC in normal group were significantly decreased at 10 and 20 d after treatment(P0.05 to P0.01).Compared with before treatment,the NIHSS scores in two groups were decreased at 10 and 20 d after treatment(P0.01).The difference of NIHSS scores in two groups had no statistical significance at 10 d after treatment(P0.05),the NIHSS scores in intensive group was lower than that in normal group at 20 d after treatment(P0.01).Conclusion

       

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