埃索美拉唑联合早期肠内生态免疫营养对重症急性胰腺炎患者肠黏膜屏障功能的影响  

Effects of Esomeprazole Combined With Early Enteral Ecoimmunonutrition on Intestinal Mucosal Barrier Function in Patients With Severe Acute Pancreatitis

作　　者：田笑笑[1] 杜浩[2] 白艳丽[1] 朱晶晶[1] 张瑜[1] 张亚历[3] 

机构地区：[1]河南科技大学第一附属医院消化内科,河南省洛阳市471003 [2]河南科技大学第一附属医院骨外科,河南省洛阳市471003 [3]南方医科大学南方医院消化内科

出　　处：《中国全科医学》2015年第20期2471-2474,共4页Chinese General Practice

摘　　要：目的探讨埃索美拉唑联合早期肠内生态免疫营养(EIN)治疗对重症急性胰腺炎(SAP)患者肠黏膜屏障功能的影响。方法选择河南科技大学第一附属医院消化内科及ICU于2012年1月—2014年6月收治的68例SAP患者为研究对象,依据不同营养方法将患者分为全肠外营养组(TPN组,n=21)、EIN组(n=24)和埃索美拉唑联合EIN组(E+EIN组,n=23),检测并对比分析3组治疗前后肠黏膜屏障指标,包括血浆内毒素、D-乳酸、二胺氧化酶(DAO)水平及尿乳果糖与甘露醇比值(L/M)的差异。结果治疗后第7、14天,3组患者各黏膜屏障指标均低于治疗前,差异有统计学意义(P<0.05),EIN组、E+EIN组患者治疗后血浆内毒素、D-乳酸、DAO水平及尿L/M低于TPN组,E+EIN组低于EIN组,差异有统计学意义(P<0.05)。结论埃索美拉唑联合EIN可有效保护肠黏膜屏障,维护肠道黏膜屏障的完整性,疗效优于单纯EIN和TPN。Objective To analyze the effects of esomeprazole combined with early enteral ecoimmunonutrition on intestinal mucosal barrier function in patients with severe acute pancreatitis（SAP）.Methods We enrolled 68 SAP patients who were admitted into the Department of Gastroenterology and the ICU of the First Affiliated Hospital of Henan University of Science and Technology from January 2012 to June 2014.According to different nutrition methods,the subjects were divided into three groups：TPN group（n = 21）,EIN group（n = 24） and E ＋ EIN group（n = 23）.The indicators of intestinal mucosal barrier function after intervention were examined and analysed,including the levels of plasma endotoxin,D-lactate,diamine oxidase（DAO） and lactulose/mannitol（L/M） in urine.Results On Day 7 and 14,the three groups were higher（P 0.05） in the indicators than before intervention.The EIN group and E ＋ EIN group were lower than TPN group in the levels of plasma endotoxin,D-lactate,DAO and L/M in urine（P 0.05）,and the E ＋ EIN group was lower（P 0.05） than the EIN group in the indicators.Conclusion Esomeprazole combined with early enteral ecoimmunonutrition could effectively protect intestinal mucosal barrier and maintain its integrity.The effect is better than simply using EIN or TPN.

关 键 词：胰腺炎 肠道营养 埃索美拉唑 肠黏膜 

分 类 号：R576[医药卫生—消化系统]