基于肠道微生物组学分析不同比例肠内营养制剂对神经外科重症患者肠道功能、免疫功能的影响

使用肠道微生物组学技术探讨不同比例的肠内营养制剂对于神经外科重症患者肠道功能与免疫功能的影响。

选取2022年7月至2023年6月在我院进行治疗的神经外科重症患者，随机分为观察组、对照组，每组60例。对照组使用2/3标准剂量，观察组使用1/3标准剂量，对比两组患者的营养指标、免疫功能指标、粪便菌群alpha多样性、7 d内血糖水平、胰岛素的使用总量及并发症的发生情况。

在进行治疗后，观察组的总蛋白、白蛋白、前白蛋白及血红蛋白指标均显著高于对照组，差异均有统计学意义（均P＜0.05）；观察组患者的IL-6、IL-10及IL-17指标均显著低于对照组，差异均有统计学意义（均P＜0.05）；观察组患者粪便菌群中的Ace指数、Chao1指数、Shannon指数均显著高于对照组，Simpson指数显著低于对照组，差异均有统计学意义（均P＜0.05）；观察组血糖＞10.0 mmol/L的次数和胰岛素使用总量显著低于对照组，差异均有统计学意义（均P＜0.05）；两组患者在治疗时没有出现比较严重的并发症，观察组发生并发症人数显著低于对照组，差异有统计学意义（χ² = 3.927，P = 0.048）。

对于神经外科重症患者使用1/3标准剂量的营养支持能够改善患者的肠道功能和免疫指标，值得在临床中推广。

Effects of different proportions of enteral nutrition preparations on intestinal function and immune function in critically-ill patients of neurosurgery based on intestinal microbiome

ObjectiveUsing gut microbes omics technology to explore the use of different proportions of enteral nutrition preparations for neurosurgery patients with severe intestinal function and the influence of immune function. MethodsPatients admitted to the neurosurgery from June 2022 to June 2023 were included and randomly divided into the observation group (n=60) or control group (n = 60). The control group received 2/3 standard dose, while the observation group received 1/3 standard dose. The nutritional indices, immune function indices, alpha diversity of fecal flora, blood glucose level within 7 days, total insulin use and incidence of complications were compared between the two groups. ResultsAfter treatment, the total protein, albumin, prealbumin and hemoglobin in the observation group were significantly higher than those in the control group (all P＜0.05); the indicators of IL-6, IL-10 and IL-17 were significantly lower than those in the control group (all P＜0.05). The Ace, Chao1 and Shannon indexes of fecal bacteria in observation group were significantly higher, while Simpson index were significantly lower than those in control group, respectively (all P＜0.05). The times of blood glucose ＞100 mmol/L and total insulin dosage in observation group were lower than in the control group, with statistically difference (all P＜0.05). No serious complications occurred in the two groups, and the number of complications in observation group was significantly lower than that in the control group (χ2 = 3.927, P = 0.048). ConclusionUse of 1/3 standard dose of nutritional support for critically-ill patients of neurosurgery can improve the intestinal function and immune indexes of patients, and is worthy of clinical promotion.