四联活菌制剂对危重症患者肠屏障功能障碍的影响及疗效观察  

Quadruple viable preparations for critically ill patients with intestinal barrier dysfunction and its clinical efficacy

作　　者：乌力扎巴依尔.永胡尔 范旻[2] 

机构地区：[1]新疆医科大学公共卫生学院营养与食品卫生学教研室,新疆乌鲁木齐830000 [2]新疆维吾尔自治区人民医院临床营养研究所,新疆乌鲁木齐830000

出　　处：《中国微生态学杂志》2016年第7期775-777,共3页Chinese Journal of Microecology

基　　金：国家"十二五"科技支撑计划项目(2012BAI35B03)

摘　　要：目的探讨双歧杆菌、嗜热链球菌、保加利亚乳杆菌和嗜酸乳杆菌四联活菌制剂对危重症患者肠道屏障功能的影响及疗效观察。方法选择新疆维吾尔自治区人民医院重症监护室2014年5月至2015年2月收治的危重症患者中64例肠道屏障功能障碍的患者,按照随机数字表法随机分为观察组和对照组。两组患者均给予基础治疗加营养治疗。在营养治疗方面,对照组给予常规营养治疗,观察组在常规营养治疗的基础上加用四联活菌制剂,800mL/d。观察两组患者在治疗前及治疗后7、14d外周血二胺氧化酶(DAO),血浆D-乳酸,血清内毒素的变化;观察两组患者腹泻治疗情况。结果两组患者治疗后7、14d肠黏膜屏障功能3项指标有明显降低,观察组治疗14d后肠黏膜屏障功能3项指标较对照组降低幅度更大,差异有统计学意义(P<0.01)。患者治疗腹泻总有效率观察组为96.7%,对照组为70.0%,两组间比较差异有统计学意义(P<0.05)。结论四联活菌制剂可以明显改善危重症患者肠道通透性,同时改善肠道微生态平衡,修复肠黏膜屏障功能,对危重症患者腹泻有显著的治疗作用,进而改善患者的预后,提高临床疗效,应在临床上推广应用。Objective Bifidobacterium, Streptococcus thermophilus, Lactobacillus bulgaricus and Lactobacillus acidophilus quadruple viable preparations for critically ill patients with intestinal barrier function and its clinical efficacy.Methods Critically ill patients Xinjiang Uygur Autonomous Region People＇s Hospital intensive care unit from May 2014 to February 2015 were treated intestinal barrier dysfunction in 64 patients, according to a random number table, randomly divided into observation group and control group. Two groups of patients were given basic treatment plus nutritional therapy. In terms of nutrition therapy, the control group received conventional nutrient treatment, observation group received routine therapy based on the use of nutrition quadruple viable preparations, 800 mL/d. After the two groups were observed in the peripheral blood before treatment and 7,14 d diamine oxidase （DAO）, plasma D-lactic acid, changes in serum endotoxin; treatment of diarrhea were observed. Results After treatment 7, 14 d intestinal mucosal barrier function three indicators had decreased, the observation group after treatment 14 d reduced intestinal mucosal barrier function of three indicators than the control group even more sharply （P〈0.01）, the difference was statistically significant. Observation group treatment diarrhoea total effective rate was 96.7%, while control group was 70.0%, comparatived differences between the two groups had statistical significance （P〈0.05）. Conclusion Quadruple viable preparations can significantly improve the intestinal permeability in critically ill patients, while improving the intestinal microflora balance, repair intestinal barrier function in critically ill patients with diarrhea have significant therapeutic effect, thereby improving the prognosis of patients and improve clinical efficacy, clinical application should be promoted.

关 键 词：肠道屏障功能 肠黏膜通透性 肠道菌群 微生态制剂 

分 类 号：R581[医药卫生—内分泌]