补充胆固醇对低胆固醇血症肺部感染患者营养状况及疾病严重程度的影响研究

摘要

目的：探讨补充胆固醇对低胆固醇血症肺部感染患者营养状况及疾病严重程度的影响及可能的分子生物学机制。方法2011年1月—2012年12月，选取首都医科大学附属北京友谊医院感染内科住院诊断为肺部感染的47例患者，入院时检测血浆总胆固醇低于3.9 mmol/ L 被诊断为低胆固醇血症，应用随机数字方法将患者分为试验组（n ＝23）和对照组（n ＝24）。两组患者均按相同能量标准给予平衡膳食，试验组患者额外补充胆固醇600 mg，干预10 d 后对比分析试验组和对照组总胆固醇等生化指标、细胞因子、营养状况和疾病严重程度变化情况。结果干预10 d后，两组总胆固醇、清蛋白、前清蛋白、超敏 C 反应蛋白、白介素6、疾病严重程度比较，差异均有统计学意义（P ﹤0.05）。对照组和试验组每日总能量及营养素摄入量比较，差异均无统计学意义（P ﹥0.05）。干预10 d 后，两组营养状况比较，差异有统计学意义（P ﹤0.05）。结论适当补充胆固醇，可以升高血浆胆固醇水平，并且可能通过降低机体促炎细胞因子，升高抗炎细胞因子水平来降低疾病严重程度；同时显著升高血浆清蛋白及前清蛋白水平，改善患者营养状况。%Objective To investigate the effect of cholesterol supplement on improving nutritional status and disease severity of patients with hypocholesterolemia and pulmonary infection and the possible molecular biological mechanism. Methods From January 2011 to December 2012,we selected 47 patients who were hospitalized and diagnosed with pulmonary infection in the Department of Internal Medicine of Beijing Friendship Hospital of Capital Medical University. At admission,patients with detected level of plasma total cholesterol(TC)lower than 3. 9 mmol/ L were diagnosed as hypocholesterolemia. Random number table method was employed to randomly divide patients into trial group(n = 23)and control group(n = 24). The two groups were given balanced diet with the same energy scale,and the trial group was also given 600 mg cholesterol supplement. After 10- day intervention,the changes of TC and other biochemical criteria,cytokines,nutritional status and disease severity of the two groups were observed. Results After 10 - day intervention, the two groups were different in TC, plasma albumin, prealbumin,hs-CRP,IL-6 and disease severity were statistically significant(P ﹤ 0. 05). There was no significant difference in total energy and nutrient intake between the control group and the experimental group(P ﹥ 0. 05). After 10 - day intervention, there was significant difference in nutritional status between the two groups(P ﹤ 0. 05). Conclusion The proper supplement of cholesterol could increase the plasma cholesterol level and may improve the level of anti - inflammatory cytokine by reducing proinflammatory cytokines;it also significantly improve the levels of plasma albumin and prealbumin and thus improve the nutritional status of patients.