免疫肠内营养对重症急性胰腺炎病人肠黏膜屏障和细胞因子的影响  

Influence of immunity enteral nutrition on cytokine and intestinal mucosal barrier in patients of severe acute pancreatitis

作　　者：王庆华[1] 管清海[2] 商琼琼[1] 杨斌[2] 李玲[2] 陈强谱[2] WANG Qing-hua GUAN Qing-hai SHANG Qiong-qiong YANG Bin LI Ling CHEN Qiang-pu(School of Nursing Clinical Nutrition Support Center,Binzhou Medical University, Binzhou 256603, Shandong , China)

机构地区：[1]滨州医学院护理学人文教研室,山东滨州256603 [2]滨州医学院附属医院临床营养中心,山东滨州256603

出　　处：《肠外与肠内营养》2016年第5期275-278,共4页Parenteral & Enteral Nutrition

基　　金：山东省医药卫生科技发展计划项目(2015WS0502)

摘　　要：目的:探讨免疫肠内营养(IEN)治疗对重症急性胰腺炎(SAP)病人肠黏膜屏障和细胞因子的影响。方法:将46例病人随机分为IEN组和对照组,每组23例。对照组病人采用传统保守治疗,IEN组在保守治疗基础上给予IEN治疗。观察两组病人住院期间血、尿淀粉酶恢复时间,腹痛缓解时间和两组间的并发症、治愈等情况以及细胞因子和肠黏膜屏障功能的变化。结果:两组病人腹痛缓解时间、血和尿淀粉酶变化、并发症的发生率和治愈率等比较均有显著性差异(P<0.05)。治疗前、治疗后第7和第14天分别检测T淋巴细胞亚群(CD3^+、CD4^+、CD8^+和CD4^+/CD8^+)、炎性细胞因子(TNF-α、IL-6、IL-8)、血D-乳酸和内毒素水平变化均有显著性差异(P<0.05)。结论:IEN可改善SAP病人的肠黏膜屏障功能和细胞因子功能。Objective ： To study the effect of immunity enteral nutrition （IEN） on cytokine and intestinal mucosal barrier in patients of severe acute pancreatitis （SAP）. Methods： The 23 patients with severe acute pancreatitis were treated for 7 -14 days by immunity enteral nutrition as IEN group and the control group was received normal treatment respectively. The changes of cytokine and immunity and intestinal mucosal barrier index was determined. Results ： At the 14 th days after IEN, the serum levels of TNF-α, IL-6, IL-8, CD3 and CD4 positive cells and CD4/CD8 value in IEN group recovered to the normal level and were higher than those of the control group （P 〈 0.05, P 〈 0.01 ）. Conclusion ： Immunity enteral nutrition can reduce serum levels of TNF-α, IL-6 and IL-8, enhance T-lymphocyte immune function and improve plasma D-lactate levels in patients of severe acute pancreatitis.

关 键 词：免疫肠内营养 重症急性胰腺炎 免疫功能 肠黏膜屏障 细胞因子 

分 类 号：R576[医药卫生—消化系统]