益生菌对重症感染性肺炎病儿血糖的稳定作用及其机制研究  

The effects of probiotics on the stabilization of blood glucose and the mechanism in children with severe infectious pneumonia

作　　者：王玉[1] 杨中文[1] 史长松[1] 张豫华[1] 高丽[1] 

机构地区：[1]河南省人民医院儿科,河南郑州450003

出　　处：《肠外与肠内营养》2017年第3期159-163,共5页Parenteral & Enteral Nutrition

基　　金：河南省医学科技攻关计划项目(201403193)

摘　　要：目的:探讨益生菌对重症感染性肺炎病儿血糖水平的调节及作用机制。方法:前瞻性纳入重症感染性肺炎病儿80例,随机分为两组,对照组给予常规治疗,治疗组采用常规治疗加用益生菌。两组病儿分别于入组当天和治疗第8天监测血糖浓度,并测定血浆硫化氢(H2S)、D-乳酸以及粪便短链脂肪酸(乙酸、丙酸、正丁酸)水平,同时观察两组病儿的血糖变化、波动情况和预后,并进行分析。结果:两组病儿入组当天的各项指标均无显著性差异(P>0.05)。治疗第8天时,治疗组病儿血浆H2S浓度和粪便中乙酸、正丁酸水平明显高于对照组(P<0.05);同时,治疗组病儿血浆D-乳酸浓度也较对照组明显降低(P<0.05)。治疗第8天,治疗组病儿的血糖水平和高波动比例显著低于对照组(32.5%)(P<0.05)。治疗组病儿的临床治愈率也明显高于对照组。而且血糖浓度与H2S、乙酸水平呈明显负相关,与D-乳酸浓度呈显著正相关(P<0.05)。结论:重症感染性肺炎病儿应用益生菌可调整肠道菌群结构,加强肠道屏障功能,增加血浆H2S的浓度,调节和稳定血糖水平,并改善临床预后。Objective： To investigate the effects of probiotics on the stabilization of blood glucose and its mechanism in children with severe infectious pneumonia. Methods： Eighty children with severe infectious pneumonia admitted to PICU were enrolled in the clinical trial prospectively. They were divided into two groups by random. Forty patients given probiotics were regarded as treatment group, the others not given probiotics were considered to be controlled group, in addition to the regular therapy. Blood glu- cose, plasma H2 S, D-lactate and acetic acid, propionic acid and butyric acid concentrations in stools were measured respectively at the beginning of the treatment and on day 8 after the treatment. At the same time the changes of blood glucose, fluctuation of them and prognosis were examined. Results： There was no significance in all the parameters of the two groups at the beginning of the treatment （P 〉 O. 05 ）. The levels of plasma n2 S and acetic acid, butyric acid in the stools of the probiotics group was （ 24.6± 7.4 ）μmoL/L, （ 32.8± 8.6 ） μmol/g, （ 15.2 ± 5.2 ）μmol/g on the day 8 respectively ; but the concentration of these parameters in the control group was （20.9±7.4 ）μmol/L, （28.6 ± 7.9 ） μmol/g, （12.9±5.0）μmol/g. Meanwhile the level of D-lactate in patients given probioties （1.25± 0.39 ）μg/ ml was significantly lower than that the control group （ 1.45 ±0.4 ）μg/ml. The blood glucose （ 6.1 ±2.7） mmol/L was lower than than in the other group （7.4± 2.7） mmol/L on day 8. And a higher recov- ery rate was found in probiotic group. Furthermore, blood glucose and H2S, acetic acid levels expressed negative correlation at 8 day;but positive correlations were found between blood glucose and D-lactate （P 〈 0. 05 ）. Conclusion： Application of probiotics to children with severe infectious pneumonia can moderate the structure of enterobacteria, reinforce the intestinal barrier and elevate the levels of plasma H2S and had positive effects on

关 键 词：益生菌 重症感染性肺炎 儿童 血糖 胰岛素抵抗 

分 类 号：R459.3[医药卫生—治疗学] R725.6[医药卫生—临床医学]