本文關(guān)鍵詞：兩種腸內(nèi)營養(yǎng)混懸液在糖尿病伴高尿酸血癥患者中的應(yīng)用研究　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 糖尿病 高尿酸血癥 腸內(nèi)營養(yǎng)混懸液 腸內(nèi)營養(yǎng)

【摘要】：目的探究康全力和能全力兩種腸內(nèi)營養(yǎng)混懸液對2型糖尿病伴高尿酸血癥患者血糖、胰島素用量、血尿酸、白蛋白、前白蛋白、甘油三酯、膽固醇等代謝指標(biāo)和安全性指標(biāo)的影響,分析兩種腸內(nèi)營養(yǎng)混懸液在2型糖尿病伴高尿酸血癥患者中應(yīng)用的有效性、安全性,為臨床中合理選用腸內(nèi)營養(yǎng)混懸液提供一定的理論依據(jù)。方法將符合納入標(biāo)準(zhǔn)的74例2型糖尿病伴高尿酸血癥患者按照隨機原則分為能全力組和康全力組,每組37名患者,分別經(jīng)鼻胃管給予能全力或康全力腸內(nèi)營養(yǎng)混懸液并記錄兩組患者的液體出入量及胰島素用量。在給予兩種腸內(nèi)營養(yǎng)混懸液前以及腸內(nèi)營養(yǎng)的第7、10天分別采集兩組患者的空腹靜脈血,監(jiān)測其血糖、血尿酸、白蛋白、前白蛋白、甘油三酯、膽固醇等代謝指標(biāo)的水平,并詳細記錄患者在腸內(nèi)營養(yǎng)期間發(fā)生不良反應(yīng)與并發(fā)癥的情況作為安全性指標(biāo)。應(yīng)用重復(fù)測量、t檢驗、c2檢驗等統(tǒng)計學(xué)方法對收集的資料進行統(tǒng)計學(xué)分析。結(jié)果兩組最終各收集有效病例35份。1.兩組患者間的一般資料及腸內(nèi)營養(yǎng)前各指標(biāo)的基線值均無顯著性差異(P0.05),具有可比性。2.腸內(nèi)營養(yǎng)期間兩組患者胰島素用量的重復(fù)測量分析發(fā)現(xiàn),時間效應(yīng)、處理效應(yīng)以及交互效應(yīng)均有統(tǒng)計學(xué)意義(P時間=0.039,P處理=0.025,P交互0.001)。在不同時間點對兩組患者間胰島素用量進行比較,康全力組患者腸內(nèi)營養(yǎng)第7、10天的胰島素用量顯著低于能全力組(t=2.206,P=0.031;t=3.579,P=0.001)。3.兩組患者血糖水平重復(fù)測量分析發(fā)現(xiàn),時間效應(yīng)、處理效應(yīng)以及交互效應(yīng)均有統(tǒng)計學(xué)意義(P時間=0.006,P處理0.001,P交互0.001)。在不同時間點對兩組患者間血糖水平進行比較,康全力組患者腸內(nèi)營養(yǎng)第7、10天的血糖水平顯著低于能全力組(t=4.071,P0.001;t=4.799,P0.001)。4.腸內(nèi)營養(yǎng)期間兩組患者出入量的變化均無統(tǒng)計學(xué)意義(P0.05),所以可排除出入量對兩組患者血尿酸水平的影響。腸內(nèi)營養(yǎng)期間康全力組患者血尿酸水平由(494.83±60.82)μmol/L上升到(499.51±63.20)μmol/L,但兩組患者血尿酸水平重復(fù)測量分析中的時間效應(yīng)、處理效應(yīng)以及交互效應(yīng)均無統(tǒng)計學(xué)意義(P時間=0.578,P處理=0.893,P交互=0.066)。5.腸內(nèi)營養(yǎng)期間兩組患者白蛋白水平僅時間效應(yīng)有統(tǒng)計學(xué)意義(P時間0.001),其它比較均無統(tǒng)計學(xué)意義(P0.05)。兩組患者前白蛋白水平重復(fù)測量分析發(fā)現(xiàn),時間效應(yīng)、處理效應(yīng)和交互效應(yīng)均有統(tǒng)計學(xué)意義(P時間0.001,P處理=0.044,P交互0.001)。在不同時間點對兩組患者間前白蛋白水平進行比較,康全力組患者腸內(nèi)營養(yǎng)第10天的前白蛋白水平顯著高于能全力組(t=2.823,P=0.006)。6.腸內(nèi)營養(yǎng)期間,雖然能全力組患者甘油三酯水平有所下降,康全力組患者甘油三酯水平有所上升,但兩組患者甘油三酯水平的時間效應(yīng)、處理效應(yīng)、交互效應(yīng)以及兩組患者間同期甘油三酯水平比較,差異均無統(tǒng)計學(xué)意義(P0.05)。兩組患者膽固醇水平的時間效應(yīng)、處理效應(yīng)以及交互效應(yīng)均有統(tǒng)計學(xué)意義(P時間0.001,P處理=0.043,P交互=0.036)。在不同時間點對兩組患者間膽固醇水平進行比較,康全力組患者腸內(nèi)營養(yǎng)第10天的膽固醇水平顯著高于能全力組(t=2.435;P=0.018)。7.對兩組患者腸內(nèi)營養(yǎng)期間出現(xiàn)的不良反應(yīng)以及并發(fā)癥情況進行比較,差異不具有顯著性(P0.05)。結(jié)論短期(10天)內(nèi)應(yīng)用康全力較能全力具有血糖水平穩(wěn)定、胰島素用量少,且能更好的改善蛋白質(zhì)代謝的優(yōu)點。但能全力能夠更好的改善患者膽固醇水平。短期(10天)內(nèi)兩者對血尿酸、甘油三脂水平等均未產(chǎn)生明顯影響,且均具有良好的安全性。因此,這兩種腸內(nèi)營養(yǎng)混懸液對2型糖尿病伴高尿酸血癥患者均具有一定的療效,并且康全力是此類患者短期(10天)內(nèi)應(yīng)用更為理想的營養(yǎng)制劑,但如果長時間使用需關(guān)注患者血尿酸水平升高的風(fēng)險。
[Abstract]:Objective to explore the best and to Kang two Enteral Nutritional Suspension on type 2 diabetes mellitus patients with hyperuricemia, blood glucose, insulin dosage, blood uric acid, albumin, pre albumin, triglyceride, cholesterol and other metabolic effects and safety indexes, analysis of two kinds of Enteral Nutritional Suspension in the effectiveness of the application of hyperuricemia in patients with type 2 diabetes with safety, for reasonable selection of Enteral Nutritional Suspension to provide a theoretical basis for clinical application. Methods 74 patients met the inclusion criteria of type 2 diabetes mellitus complicated with hyperuricemia were randomly divided into the study group and to Kang group, each group had 37 patients, respectively by nasogastric tube or to Kang to Enteral Nutritional Suspension and record the two groups of patients of liquid intake and output the amount of insulin given in two. In the former Enteral Nutritional Suspension and enteral nutrition in the 7,10 don't talent acquisition Fasting venous blood of two groups of patients, monitor their blood glucose, blood uric acid, albumin, pre albumin, triglyceride, cholesterol metabolism index level, and during enteral nutrition in patients with documented adverse reactions and complications as safety index. Application of repeated measurement, t test data, the statistical method of C2 test the collected for statistical analysis. Results there were no significant differences between the two groups of general information and intestinal each collection of 35 effective cases of.1. between the two groups in the nutrition of each index before the baseline (P0.05), it can be compared with repetitive measurement and analysis of two groups of patients with insulin dosage of.2. during enteral nutrition found the effect of time, treatment effects and interactions were statistically significant (P =0.039, P =0.025, P 0.001 interactive). At different time points of two groups of patients were compared between the dosage of insulin, to Kang group Enteral nutrition insulin dosage in 7,10 days was significantly lower than that of the study group (t=2.206, P=0.031; t=3.579, P=0.001).3. two group the blood glucose levels of patients with repeated measurement analysis, time effect, treatment effects and interactions were statistically significant (P =0.006, P 0.001, P 0.001 interactive) at different time points to. Two groups of patients were compared between the blood glucose level, Kang group full enteral nutrition in patients with 7,10 days blood glucose level was significantly lower than the study group (t=4.071, P0.001; t=4.799, P0.001).4. during enteral nutrition in two groups and changes were not statistically significant (P0.05), so we can exclude the influence of quantity of two groups of patients with serum uric acid levels. During enteral nutrition Kang group to serum uric acid levels by (494.83 + 60.82) mol/L to (499.51 + 63.20) mol/L, but the two groups of serum uric acid in patients with repeated measurement and analysis of time effect in the Office Physical effects and interaction effects were not statistically significant (P =0.578, P =0.893, P interactive =0.066) was statistically significant.5. during enteral nutrition in patients with albumin levels in the two groups only time effect (P 0.001), the other had no statistical significance (P0.05). The two groups of patients with serum prealbumin level analysis of repeated measurement that time effect, treatment effects and interaction effects were statistically significant (P 0.001, P =0.044, P 0.001 interactive). At different time points of two groups of patients were compared between the level of serum prealbumin, albumin levels to Kang group before enteral nutrition in patients with tenth days were significantly higher than those in the study group (t=2.823, P=0.006.6.) during enteral nutrition, while the study group triglyceride levels in patients with decreased triglyceride levels in patients with Kang group all increased, but the two groups of the patients with triglyceride levels between the treatment effect and interaction effect. Comparison of effect between the two groups of patients during the same period and triglyceride levels, there were no significant differences (P0.05). The effect of time in patients with cholesterol levels in the two groups, the treatment effect and the interactions were statistically significant (P 0.001, P =0.043, P =0.036 interactive). At different time points of two groups of patients were compared between cholesterol levels Kang group, full enteral nutrition in patients with tenth days of cholesterol level was significantly higher than that of the study group (t=2.435; P=0.018) comparing.7. of two groups of patients with enteral nutrition during the adverse reactions and complications, the difference was not significant (P0.05). Conclusion the short-term (10 days) in the application to more fully Kang with stable blood sugar levels, less dosage of insulin, improve the protein metabolism and the advantages of better. But to improve cholesterol levels in patients with better short-term (10 days) in both the blood uric acid, glycerol Were not obvious effects of three lipid levels, and has good safety. Therefore, the two Enteral Nutritional Suspension has certain curative effect on type 2 diabetes mellitus patients with hyperuricemia, and to such patients is Kang short-term (10 days) in the application of more ideal nutrition preparations, but if the risk is used for a long time need to pay attention to patients with elevated level of serum uric acid.

【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.5

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