常规平衡型全营养素制剂联合乳清蛋白强化营养支持对重型颅脑损伤患者营养状态及机体免疫的影响

doi:10.3969/j.issn.1671-7171.2025.10.014

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摘要【目的】探讨常规平衡型全营养素制剂联合乳清蛋白强化营养支持对重型颅脑损伤(STBI)患者营养状态及机体免疫的影响。【方法】回顾性分析2021年5月至2024年6月本院收治的90例STBI鼻饲患者的临床资料,依据营养支持方式的不同分为强化组(n=46)和常规组(n=44)。常规组给予常规平衡型全营养素制剂鼻饲营养支持,强化组给予常规平衡型全营养素制剂联合乳清蛋白强化营养支持。干预前、干预后,比较两组患者营养状态[微型营养评定量表(MNA)评分]、血清营养指标[总蛋白(TP)、前白蛋白(PA)、白蛋白(Alb)]、免疫指标[免疫球蛋白A(Ig A)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)]、预后情况及不良反应发生情况。【结果】干预后,两组患者MNA评分均高于干预前,且强化组高于常规组,差异有统计学意义(P<0.05)。干预后,两组TP、PA、Alb水平均高于干预前,且强化组均高于常规组,差异有统计学意义(P<0.05)。干预后,强化组IgA、IgM、IgG水平均高于常规组,差异有统计学意义(P<0.05)。强化组患者住院时间短于常规组,差异有统计学意义(P<0.05);干预后,强化组美国国立卫生院神经功能缺损量表(NIHSS)评分低于常规组,日常生活能力量表(ADL)评分高于常规组,差异有统计学意义(P<0.05)。强化组、常规组不良反应发生率分别为32.61%(15/46)、38.64%(17/44),差异无统计学意义(P>0.05)。【结论】常规平衡型全营养素制剂联合乳清蛋白强化营养支持可改善STBI患者营养状态,增强免疫功能,促进神经功能的恢复,提高日常生活能力,且安全性较好。

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	姜景凤
	刘漫漫
	赵红武

关键词 ：颅脑损伤, 营养支持, 乳清蛋白, 营养状况, 免疫

Abstract：【Objective】To explore the effect of routine balanced total nutrient preparation combined with whey protein-enhanced nutritional support on the nutritional status and immune function of patients with severe traumatic brain injury (STBI). 【Methods】The clinical data of 90 STBI patients receiving nasogastric feeding in our hospital from May 2021 to June 2024 were retrospectively analyzed. They were divided into the enhanced group (n=46) and the routine group (n=44) according to different nutritional support methods. The routine group was given nutritional support with routine balanced total nutrient preparation, while the enhanced group was given nutritional support with routine balanced total nutrient preparation combined with whey protein enhancement. Before and after intervention, the nutritional status [Mini Nutritional Assessment (MNA) score], serum nutritional indicators [total protein (TP), prealbumin (PA), albumin (Alb)], immune indicators [immunoglobulin A (IgA), immunoglobulin M (IgM), immunoglobulin G (IgG)], prognosis and incidence of adverse reactions were compared between the two groups.【Results】After intervention, the MNA scores of both groups were higher than those before intervention, and the enhanced group was higher than the routine group, with a statistically significant difference (P<0.05). After intervention, the levels of TP, PA and Alb in both groups were higher than those before intervention, and the enhanced group was higher than the routine group, with statistically significant differences (P<0.05). After intervention, the levels of IgA, IgM and IgG in the enhanced group were higher than those in the routine group, with statistically significant differences (P<0.05). The length of hospital stay in the enhanced group was shorter than that in the routine group, with a statistically significant difference (P<0.05); after intervention, the National Institutes of Health Stroke Scale (NIHSS) score of the enhanced group was lower than that of the routine group, and the Activity of Daily Living (ADL) score was higher than that of the routine group, with statistically significant differences (P<0.05). The incidence of adverse reactions in the enhanced group and the routine group was 32.61% (15/46) and 38.64% (17/44) respectively, with no statistically significant difference (P>0.05).【Conclusion】Routine balanced total nutrient preparation combined with whey protein-enhanced nutritional support can improve the nutritional status of STBI patients, enhance immune function, promote the recovery of neurological function, improve the ability of daily living, and has good safety.

Key words： Craniocerebral Trauma Nutritional Support Lactalbumin Nutritional Status Immunity

收稿日期: 2024-12-09

中图分类号:

R651.15

引用本文:

姜景凤, 刘漫漫, 赵红武. 常规平衡型全营养素制剂联合乳清蛋白强化营养支持对重型颅脑损伤患者营养状态及机体免疫的影响[J]. 医学临床研究, 2025, 42(10): 1728-1731.
JIANG Jingfeng, LIU Manman, ZHAO Hongwu. Effect of Routine Balanced Total Nutrient Preparation Combined with Whey Protein-Enhanced Nutritional Support on Nutritional Status and Immune Function in Patients with Severe Traumatic Brain Injury. JOURNAL OF CLINICAL RESEARCH, 2025, 42(10): 1728-1731.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.10.014 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I10/1728

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