To explore the effect of enteral nutrition with pectin dietary fiber on immune and gastrointestinal functions in severe patients.

A total of 140 severe patients admitted to four hospitals from September 2019 to August 2020 were randomly divided into a control group and an observation group, with 70 cases in each group. Patients in the control group were treated with routine enteral nutrition in addition to basic treatment, while patients in the observation group were treated with enteral nutrition with pectin dietary fiber in addition to basic treatment. The levels of serum total protein, albumin, prealbumin and hemoglobin, the ratios of CD3⁺, CD4⁺ and CD8⁺ in peripheral blood T lymphocyte subsets, and the numbers of Bifidobacterium, Lactobacillus, Enterococcus and Enterobacter in feces were compared between the two groups before and after treatment. The incidence of gastrointestinal complications during the treatment was counted.

Before the treatment, the levels of serum total protein, albumin, prealbumin and hemoglobin, the ratios of CD3⁺, CD4⁺ and CD8⁺, and the numbers of Bifidobacterium, Lactobacillus, Enterococcus and Enterobacter in feces all showed no significant differences between the two groups (all P > 0.05). After the treatment, the levels of serum total protein, albumin, prealbumin and hemoglobin, the ratios of CD3⁺ and CD4⁺, and the numbers of Bifidobacterium and Lactobacillus in feces were much higher, and the ratio of CD8⁺ and the numbers of Enterococcus and Enterobacter in feces were much lower than those before the treatment in the control group and observation group (all P < 0.05). In the observation group, the levels of serum total protein [(64 ± 6) g / L vs. (60 ± 6) g / L, t = 4.065, P < 0.001], albumin [(36 ± 5) g / L vs. (33 ± 5) g / L, t = 3.255, P = 0.001], prealbumin [(144 ± 27) g / L vs. (120 ± 23) g / L, t = 5.661, P < 0.001] and hemoglobin [(106 ± 18) g / L vs. (99 ± 16) g / L, t = 2.372, P = 0.019], the ratio of CD4⁺ [(43 ± 6)% vs. (37 ± 6)%, t = 5.709, P < 0.001], and the numbers of Bifidobacteriu [(6.6 ± 0.8) lgCFU / g vs. (4.8 ± 0.6) lgCFU / g, t = 14.503, P < 0.001] and Lactobacillu[(7.8 ± 0.9) lgCFU / g vs. (6.1 ± 0.8) lgCFU / g, t = 11.689, P < 0.001] in feces increased markedly, and the ratios of CD3⁺ [(64 ± 7)% vs. (69 ± 8)%, t = 6.045, P < 0.001] and CD8⁺ [(21 ± 4)% vs. (25 ± 4)%, t = 6.765, P < 0.001] and the numbers of Enterococcus [(3.2 ± 0.5) lgCFU / g vs. (4.7 ± 0.6) lgCFU / g, t = 15.021, P < 0.001] and Enterobacter [(4.3 ± 0.6) lgCFU / g vs. (6.9 ± 0.8) lgCFU / g, t = 22.190, P < 0.001] in feces decreased obviously as compared with the control group after the treatment. Meanwhile, the incidence of abdominal distention, diarrhea, vomiting, constipation, reflux and aspiration pneumonia in the observation group was much lower than that in the control group ( χ² = 37.428, 19.606, 15.035, 10.570, 9.115, 6.269; all P < 0.05).

The enteral nutrition with pectin dietary fiber can improve the nutritional status and immune function, and reduce the occurrence of gastrointestinal complications in severe patients.