Effect of ecological immune-enhanced enteral nutrition on patients with gastrointestinal fistulas.

The aim of this study was to determine the effects of early ecological immune-enhanced enteral nutrition on the nutritional status, immune function and intestinal mucosal barrier in patients with gastrointestinal fistulas.54 patients with gastrointestinal fistulas were randomized to either the ecological immune-enhanced enteral nutrition group (EIEN group, 28) or the parenteral nutrition group (PN group, 26). The changes in the immunity, nutrition index and intestinal mucosal barrier indexes before the ecological immune-enhanced enteral nutrition support and at 7 days and 14 days after the ecological immune-enhanced enteral nutrition support were determined.Compared with the PN group, the indexes of the CD3 and CD4 positive cells, the CD4/CD8 values and the plasma levels of IgA and IgM were significantly higher than those in EIEN group (p<0.05). Moreover, with EIEN nutritional support, the nutrition indexes, such as the plasma ALB, PA and TFN, and the intestinal mucosal barrier index (the plasma D-lactate levels and endotoxin levels), also recovered gradually to normal levels and were higher than those of the PN group (p<0.05).For patients with gastrointestinal fistulas, ecological immune-enhanced enteral nutrition can not only improve the cellular immunity function, humoral immunity, and nutritional status but also enhance the intestinal mucosal barrier.