ABSTRACT
Objective To observe the effect of early enteral nutrition (EN) on immune function in patients with severe acute pancreatitis (SAP). Methods Nineteen patients with SAP admitted to Yinzhou People's Hospital of Ningbo City from March 11, 2015 to December 16, 2016 were enrolled, they were divided into two groups according to the different times of EN given, 11 patients who were early supported with EN were assigned in the research group and another 8 patients whose EN support was delayed were included in the control group. The patients in two groups were treated with routine non-operative western medicine after admission, and the jejunal nutritional tube was placed in the nasal cavity for EN administration. The research group was given early EN beginning at 72 hours after admission, on the first day, 250 mL sugar saline was administered at a rate of 60 mL/h, and on the second day and afterward, it was changed to 200 mL Ruineng (a commercial kind of EN); in the control group, the EN began on 7 to 10 days after admission, using the same principle and method as the research group; EN was given for 3 weeks in both groups. Venous blood was collected from each patient before and after the EN support, and immunoglobulin (IgG, IgM and IgA) levels were determined by immunoturbidimetry, the time of improved Marshall score ＜ 1 was observed. Results The levels of immunoglobulin IgG (g/L: 11.13±2.56 vs. 8.17±1.12), IgM (g/L: 1.71±0.96 vs. 0.76±0.71) and IgA (g/L: 3.74±1.85 vs. 2.13±0.13) in the research group after treatment were significantly higher than those before treatment (all P ＜ 0.05);the changes in the above indicators before and after treatment in the control group were not obvious [IgG (g/L): 8.32±0.93 vs. 8.21±1.04, IgM (g/L): 0.87±0.73 vs. 0.81±0.66, IgA (g/L): 2.15±0.37 vs. 2.11±0.17]. The levels of IgG, IgM and IgA in the research group after treatment were significantly higher than those in the control group (all P ＜ 0.05), the time of Marshall score ＜ 1 was siginificantly shorter than the research group than that in control group (days: 12.31±1.27 vs. 16.18±1.13, P ＜ 0.05). Conclusion Administration of EN as early as possible can effectively enhance the immune function of patients with SAP and improve their prognosis.