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目的：探讨肠内营养对长期禁食危重症患者炎性因子和免疫功能的影响。方法：选取我院收治的已禁食 14 天以上的危重病人 56 例，分别于实施肠内营养前，实施肠内营养后第 1， 3， 7 天检测患者外周血中的内毒素、肿瘤坏死因子 -琢、 C 反应蛋白、白细胞、白细胞介素及 T 淋巴细胞亚群和抗组织相容性抗原 -DR 水平，分析肠内营养实施前后指标。结果：实施肠内营养第 1， 3 天内毒素、肿瘤坏死因子 -琢、 C 反应蛋白、白细胞、白细胞介素 -1 及白细胞介素 -6 水平高于实施前，差异均有统计学意义(P<0.05)；实施肠内营养第 7 天 CD4、 CD4/CD8 水平高于实施前，差异有统计学意义（ P<0.05）；内毒素、肿瘤坏死因子 -琢、白细胞、 C 反应蛋白、白细胞介素 -1、白细胞介素 -6、白细胞介素 -4、白细胞介素 -10、 CD3、抗组织相容性抗原 -DR 差异无统计学意义（ P>0.05）。结论：危重病人在长期禁食后恢复肠内营养后初期全身炎症反应明显，随着实施过程逐步减轻，并可增强患者免疫功能。

英文摘要:

Objective:To explore the effects of enteral nutrition on inflammation factors and immune function in critically ill patients with long-term fasting.Methods:56 critically ill patients who were treated in our hospital and had fasted for 1 4 days or more were selected, the levels of endotoxin, tumor necrosis factor-琢, C reactive protein,white blood cells, interleukin, T lymphocyte subsets and histocompatibility antigens resistance-DR in peripheral blood were measured before enteral nutrition and on 1 , 3, 7 days after enteral nutrition, and the indexes were compared before and after enteral nutrition.Results:The levels of endotoxin, tumor necrosis factor-琢, C reactive protein, white blood cells, interleukin-1 and interleukin-6 after 1, 3 days of enteral nutrition were higher than before enteral nutrition, and the difference was statistically significant (P<0.05); The levels of CD4, CD4/CD8 after 7 days of enteral nutrition was higher than before enteral nutrition, the differences were statistically significantly (P<0.05); There was no statistical difference in enteral nutrition, tumor necrosis factor-琢, C reactive protein,interleukin-1 , interleukin-6, interleukin-4, interleukin-10,CD3 or histocompatibility antigens resistance-DR (P>0.05).Conclusion:Systemic inflammatory responses in critically ill patients with long-term fasting was significant after enteral feeding, but can alleviate with the continue period of enteral feeding and can modify the immune function of patients．

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