| Background: Malnutrition is common in patients with acute stroke, it can worsen or develop in hospital. Malnutrition is significantly associated with poor outcome after stroke. However, the timing and route of nutrition support for stroke patients,and the relationship between the nutrition support and stroke outcome are unclear. Present stage we lack the data about nutritional status of stroke patients in china, and also lack multicentre controlled trial about nutrition support for stroke. Because we can't get the nutritional status of stroke patients and its variety regulations, so we can't suitably intervene the nutritional status of stroke patients.Purpose: We offered early enteral nutrition support for dysphagic patients after acute stroke, discussing the effect of nutrition support on immune function and short-term Prognosis of the patients, we aim to establish basic conception of early enteral nutrition support after acute stroke.Methods: In a prospective non-randomized controlled design, patients with dysphagia after acute stroke were selected, the patients in stroke unit were included the intervention group and received standard naso-gastric nutrition within 72 hours of admission, the patients in neurological general ward were included the control group and received feeding supervised by family members. The study was divided two sections, section A included 55 stroke patients, 27 patients were in the intervention group and 28 patients were in the control group. Total lymphocyte count(TLC),immune globulin A(IgA), immune globulin G(IgG), immune globulin M(IgM),and complement3(C3), complement4(C4) of the two groups were detected on the day of admission,10d and 21d,hypoproteinemia(serum albumin<35g/L) and infective complications of the two groups were also compared. Section B included 76 stroke patients, 39 patients were in the intervention group and 37 patients were in the control group. To observed the nutrition status(triceps skin thickness, arm muscle circumference,haemoglobin,serum albumin,and triglycerides) on the day of admission,10d and 21d , and incidence of malnutrition for 21 days and mortality for three months between the two groups , Neurological deficit was evaluated by the NIH Stroke Scale for 21 days, the Barthel Index and Modification of Rankin Scale, of which the latter scale was calculated for 90 days.Results: After 21d , the levels of TLC[1.33±0.41×10~9/L],IgA[2.24±0.81g/L], IgG[11.02±2.78g/L], and C3[1.09±0.27g/L] in intervention group were significantly higher than the levels of TLC[1.09±0.36×10~9/L,P<0.05], IgA[1.77±0.73g/L,P<0.05], IgG[9.17±2.02g/L , P < 0.01] and C3[0.94±0.21g/L , P < 0.05] in control group; Hypoproteinemia was observed in 29.6% of intervention groupwas and in 57.1% of the control group(P<0.05),the incidence of infective complications in intervention group(44.4%) was significantly lower than in control group,s(78.6%,P<0.05); the levels of triceps skin thickness[15.09±4.83mm], arm muscle circumference[24.21±1.93cm],haemoglobin[125.5±16.8g/L] and serum albumin[38.12±4.21g/L] in intervention group were significantly higher than the levels of triceps skin thickness[12.64±5.11mm,P<0.05], arm muscle circumference[23.07±1.71cm,P<0.01],haemoglobin[116.8±19.3g/L,P<0.05] and serum albumin[35.48±4.08g/L,P<0.01] in control group; Malnutrition was observed in 18.9% of the intervention group and in 41.1% of the control group(P<0.05),mortality for three months was 10.2% in the intervention group and 18.9% in the control group(P>0.05);The NIH Stroke Scale on the 21st day in the intervention group[10.56±4.75] was also significantly better than in the control group [13.24±4.26,P<0.05], the Barthel index on the 21st day(46.7±28.6 vs 33.8±31.9) and Modification of Rankin Scale on the 90th day of follow-up were not statistically significant between the two groups.Conclusion: This study suggests that early enteral nutrition support is helpful for improving immune function, decreaseing the incidence of infective complications and malnutrition, and improving short-term prognosis and neurological function of patients following acute stroke, however, improving the Barthel index and Modification of Rankin Scale need more help besides nutrition support.
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