Analysis of effect of different enteral nutrition preparations on nutritional status and glucose metabolism in elderly patients with heart failure / 中国中西医结合急救杂志

ABSTRACT

Objective To investigate the effect of different enteral nutrition (EN) preparations on nutritional status and glucose metabolism in elderly heart failure (HF) patients. Methods Eighty-two elderly HF patients were consecutively admitted to Taizhou Enze Medical Center Group Enze Hospital from January 2017 to March 2018, and they were randomly divided into a study group and a control group, each group with 41 cases. The basic treatments were the same in two groups, while the patients in study group were treated with TPF-D emulsion, and those of control group were treated with SP emulsion. Nutritional status [serum albumin (Alb), proalbumin (PA) and transferrin (TF)], glucose metabolism indexes (glucose, Betatrophin and insulin dose), cardiac function [N-terminal B-type pro-brain natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF)], high-sensitivity C-reactive protein (hs-CRP) in serum were compared between two groups after treatment, and the incidences of adverse reactions (gastric retention, diarrhea, constipation, electrolyte abnormality, pulmonary infection, dysfunction of liver) were also observed in the two groups. Results In the aspect of nutrition, no statistical significant differences in indexes were found at each time point between the two groups during the therapeutic course (all P > 0.05). In terms of glucose metabolism, the blood glucose levels in the study group were significantly lower than those in the control group on day 5 and day 7 after treatment (mmol/L: 9.73±3.69 vs. 11.56±3.78 on day 5, 8.35±2.17 vs. 10.41±2.38 on day 7, both P < 0.05); the serum Betatrophin levels in the study group were also significantly lower than those in the control group on 5 days and 7 days (μg/L: 5 days was 1.36±0.49 vs. 1.89±0.74, 7 days was 1.31±0.47 vs. 1.62±0.59, both P < 0.05); the doses of insulin used in the study group were obviously lower than those in the control group on 3, 5 and 7 days (U: 3 days was 37.86±8.49 vs. 47.84±10.33, 5 days was 29.33±7.45 vs. 38.56±9.69, 7 days was 13.35±8.56 vs. 28.49±9.77, all P < 0.05). In terms of cardiac function, the study group showed significant lower NT-proBNP levels on 3, 5 and 7 days (μg/L: 3 days was 5.8±0.8 vs. 6.2±1.0, 5 days was 3.7±0.7 vs. 4.4±0.9, 7 days was 1.9±0.5 vs. 3.1±0.7, all P <0.05]; significant higher level of LVEF in study group on 7 days (0.50±0.02 vs. 0.48±0.03, P < 0.05) and significant lower hs-CRP levels in study group on 5 days and 7 days (μg/L: 5 days was 27.12±10.58 vs. 34.41±12.69, 7 days was 15.33±9.87 vs. 22.71±11.45, both P < 0.05). In addition, compared with the control group, the incidence of gastric retention [17.07% (7/41) vs. 36.59% (15/41)], so of diarrhea [14.63% (6/41) vs. 34.15% (14/41)] and of electrolyte abnormalities [14.63% (6/41) vs. 39.02% (16/41)] were significantly lower in study group than those in the control group (all P <0.05). Conclusion Compared with SP, TPF-D not only can effectively improve the nutritional status, but also can superiorly control blood glucose, improve cardiac function and lower the incidence of adverse reactions in elderly HF patients.