Journal of Shandong University (Health Sciences) ›› 2019, Vol. 57 ›› Issue (3): 80-84.doi: 10.6040/j.issn.1671-7554.0.2018.906

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Effects of enteral and parenteral nutrition support on serum ALT, SCr and complications in patients with early severe stroke

HAO Xiaorui1, ZHAO Changsheng2   

  1. 1. Department of Cadres Medical Care;
    2. Department of Nutrition, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Published:2022-09-27

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Abstract: Objective To compare the effects of enteral and parenteral nutrition on serum alanine transaminase(ALT), serum creatinine(SCr)and complications in patients with early severe stroke. Methods A total of 60 patients with early severe stroke were randomly divided into two groups:30 patients in the parenteral group were given parenteral nutrition support, while another 30 patients in the enteral group were given early enteral nutrition support. The serum ALT and SCr before and after treatment, and incidence of complications were compared between the two groups. Results The serum ALT concentration significantly increased after treatment in both groups (P<0.01). The increase of ALT in the enteral group was significantly lower than that in the parenteral group (P<0.01). The serum SCr concentration showed comparable increase in both groups after treatment (P>0.05). The incidence of complications in the enteral group was 16.7%, which was significantly lower than 40.0% in the parenteral group (P<0.05). Conclusion Compared with parenteral nutrition support, enteral nutrition support has greater protective effects on liver function, causes fewer complications, and has better clinical effects in the treatment of early severe stroke.

Key words: Enteral nutrition, Parenteral nutrition, Early severe stroke, Serum alanine transaminase, Serum creatinine, Complications

CLC Number: 

  • R459.3
[1] 韩晓丽, 薛梅, 高云, 等. 不同类型肠内营养制剂对重症脑卒中病人营养状况的影响[J]. 肠外与肠内营养, 2015, 22(6):329-331. doi:10.16151/j.1007-810x.2015.06.003. HAN Xiaoli, XUE Mei, GAO Yun, et al. Different types of enternal nutritional powders impact on the nutritional status of patients with severe stroke [J]. Parenteral & Enteral Nutrition, 2015, 22(6):329-331. doi:10.16151/j.1007-810x.2015.06.003.
[2] 张骥, 柴文, 周鑫华, 等. 个体化营养支持在急性重症脑卒中患者中的应用效果[J]. 中国当代医药, 2018, 25(33):76-78. ZHANG Ji, CHAI Wen, ZHOU Xin-hua, et al. Application effect of individualized nutrition support in patients with acute severe stroke [J]. China Modern Medicine, 2018, 25(33):76-78.
[3] Jeremitsky E,Omert LA, Dunham CM,et al. The impact of hyperglycemia on patients with severe brain injury [J]. J Trauma, 2005, 58(1):47-50. doi:10.1097/01.TA.0000135158.42242.B1.
[4] 侯纪洪. 双歧杆菌四联活菌片联合肠内营养治疗重症脑卒中消化道并发症及对肠黏膜屏障功能的影响[J]. 药物流行病学杂志, 2016, 25(1):11-13, 42. HOU Jihong. Influence of Bifidobacterium Tetravaccine tablets combined with enteral nutrition on complications of digestive canal and intestinal mucous membrane barrier function of patients with severe stroke [J]. Chinese Journal of Pharmacoepidemiology, 2016, 25(1):11-13,42.
[5] 张俊梅, 张红梅. 免疫增强型肠内营养制剂对重症脑卒中患者近期营养状况及免疫功能的影响[J]. 中国实用神经疾病杂志, 2018, 21(19):2195-2199. ZHANG Junmei, ZHANG Hongmei. The effect of immune-enhanced enteral nutrition on short-term nutritional status and immune function in patients with severe stroke [J]. Chinese Journal of Practical Nervous Diseases,2018, 21(19):2195-2199.
[6] 冯婧, 姜嵋. 92例脑卒中患者肠外营养和肠内营养治疗效果观察[J]. 海峡药学, 2017, 29(10):97-99. FENG Jing,JIANG Mei. A comparison of application effect between enteral nutrition and parenteral nutrition in 92 severe stroke patients [J]. Strait Pharmaceutical Journal, 2017, 29(10):97-99.
[7] 李江宁. 早期免疫肠内营养支持对重症脑卒中患者营养状况和免疫功能以及预后的影响分析[J]. 检验医学与临床, 2015, 12(1):98-99, 101. doi:10.3969/j.issn.1672-9455.2015.01.039.
[8] 张立海, 王娇, 孙国娟, 等. 早期肠内营养对重症急性胰腺炎患者炎症细胞因子水平及免疫功能的影响[J]. 海南医学院学报, 2015, 21(5):758-761, 765. ZHANG Lihai, WANG Jiao, SUN Guojuan, et al. Effects of early enteral nutrition in patients with severe acute inflammatory cytokine levels and immune function [J]. Journal of Hainan Medical College, 2015, 21(5):758-761, 765.
[9] Smith EE, Saposnik G, Biessels GJ, et al. Prevention of stroke in patients with silent cerebrovascular disease:a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association [J]. Stroke, 2017, 48(2):e44-e71. doi:10.1161/STR.0000000000000116.
[10] Grinberg LT. Vascular dementia:Current concepts and nomenclature harmonization [J]. Dement Neuropsychol, 2012, 6(3):122-126. doi:10.1590/S1980-57642012DN06030002.
[11] 喻小玲, 周仕钧, 彭海峰, 等. 早期免疫肠内营养支持对重症脑卒中患者营养状况、免疫功能及预后的影响[J]. 疑难病杂志, 2014, 11:1114-1117. YU Xiaoling, ZHOUS Shijun, PEGN Haifeng, et al. Effect of early enteral nutrition support on nutritional status, immune function and prognosis for patients with severe stroke [J]. Chinese Journal of Difficult & Complicated Cases, 2014, 11:1114-1117.
[12] Aadal L, Mortensen J, Nielsen JF. Weight reduction after severe brain injury:a challenge during the rehabilitation course [J]. J Neurosci Nurs, 2015, 47(2):85-90. doi:10.1097/JNN.0000000000000121.
[13] 王玮, 张露. 谷氨酰胺联合早期肠内营养治疗急性重症胰腺炎疗效观察及对炎症因子的影响[J]. 现代消化及介入诊疗, 2016, 21(5):682-685. doi:10.3969/j.issn.1672-2159.2016.05.004. WANG Wei, ZHANG Lu. The clinical efficacy of glutamine combined with early enteral nutrition in the treatment of severe acute pancreatitis and its influence on inflammatory factors [J]. Modern Digestion & Intervention, 2016, 21(5):682-685. doi:10.3969/j.issn.1672-2159.2016.05.004.
[14] Renteria AS, Jakubowski RM, Rothwell A, et al. Oral glutamine and probiotics on enteral morbidity following autologous stem cell transplantation for plasma cell dyscrasias [J]. Biology of Blood and Marrow Transplantation, 2013, 19(2):S269-S270. doi:10.1016/j.bbmt.2012.11.371.
[15] 彭斌, 宿英英, 崔丽英, 等. 肠内营养混悬液(TPF-FOS)JEVITY在急性卒中患者中运用的安全性及有效性[J]. 中华医学杂志, 2011, 91(37):2634-2637. doi:10.3760/cma.j.issn.0376-2491.2011.37.014. PENG Bin, SU Yingying, CUI Liying, et al. Safety and efficacy of enteral nutritional suspension(TPF-FOS)JEVITY in acute stroke [J]. National Medical Journal of China, 2011, 91(37):2634-2637. doi:10.3760/cma.j.issn.0376-2491.2011.37.014.
[16] Alhambra Expósito MR,Herrera-Martínez AD,Manzano García G,et al. Early nutrition support therapy in patients with head-neck cancer [J]. Nutr Hosp, 2018, 35(3):505-510. doi:10.20960/nh.1560.
[17] Jia K, Tong X, Liang F. Effects of sequential nutritional support on nutritional status and expression of regulatory T lymphocyte in patients with early severe traumatic brain injury [J]. Neuropsychiatr Dis Treat, 2018, 14:1561-1567. doi:10.2147/NDT.S149802.
[18] Probst P, Keller D, Steimer J, et al. Early combined parenteral and enteral nutrition for pancreaticoduodenectomy -retrospective cohort analysis [J]. Ann Med Surg(Lond), 2016, 6:68-73. doi:10.1016/j.amsu.2016.02.002.
[19] Zhou WC, Li YM, Zhang H, et al. Therapeutic effects of endoscopic therapy combined with enteral nutrition on acute severe biliary pancreatitis [J]. Chin Med J, 2011, 124(19):2993-2996.
[20] Matheson PJ, Hurt RT, Mittel OF, et al. Immune-enhancing enteral diet increases blood flow and proinflammatory cytokines in the rat ileum[J]. J Surg Res, 2003, 110(2):360-370.
[21] 米元元, 沈月, 郝彬, 等. ICU患者肠内营养支持并发腹泻的循证护理实践[J]. 中华护理杂志, 2017, 52(11):1291-1298. MI Yuanyuan, SHEN Yue, HAO Bin, et al. Evidence-based nursing practice of enteral nutrition support among ICU patients with diarrhea [J]. Chinese Journal of Nursing, 2017, 52(11):1291-1298.
[22] 曾明民. 早期不同营养支持在重症监护病房患者康复中的应用效果[J]. 临床合理用药杂志, 2017(6):68-69.
[23] Koretz RL, Avenell A, Lipman TO. Nutritional support for liver disease [J]. Cochrane Database Syst Rev, 2012, 5:CD008344. doi:10.1002/14651858.CD008344.pub2.
[24] Feinberg J, Nielsen EE, Korang SK, et al. Nutrition support in hospitalised adults at nutritional risk [J]. Cochrane Database Syst Rev, 2017, 5:CD011598. doi:10.1002/14651858.CD011598.pub2.
[25] Altintas ND, Aydin K, Türkoglu MA, et al. Effect of enteral versus parenteral nutrition on outcome of medical patients requiring mechanical ventilation [J]. Nutr Clin Pract, 2011, 26(3):322-329.
[26] Xu XD, Shao F. Enteral ecoimmunonutrition reduced enteral permeability and serum ghrelin activity in severe cerebral stroke patients with lung infection [J]. Cell Biochem Biophys, 2015, 71(1):195-198. doi:10.1007/s12013-014-0184-1.
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