益生菌联合早期肠内营养治疗对重症急性胰腺炎患者血清炎性因子、肠黏膜屏障功能的影响  

Effect of probiotics combined with early enteral nutrition on serum inflammatory factors and intestinal barrier function in patients with severe acute pancreatitis

作　　者：顾慧媛 高欣[1] 钱丽娟[1] 许春芳[1] 

机构地区：[1]苏州大学附属第一医院消化内科,江苏苏州215006

出　　处：《海南医学》2017年第23期3793-3795,共3页Hainan Medical Journal

基　　金：江苏省青年医学人才项目(编号:QNRC2016722)

摘　　要：目的探讨益生菌联合早期肠内营养治疗对重症急性胰腺炎(SAP)患者血清炎性因子、肠黏膜屏障功能的影响。方法选择苏州大学附属第一医院消化科及重症医学科于2015年9月至2017年6月期间收治的34例SAP患者为研究对象,根据随机数表法分为观察组与对照组,每组17例,对照组予早期肠内营养支持治疗,观察组在此基础上联合应用双歧三联活菌胶囊治疗,疗程均为14 d。比较两组患者治疗前后的血清炎性因子[C反应蛋白(CRP)及血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]和肠功能屏障指标[内毒素及二胺氧化酶(DAO)]的变化。结果治疗后,观察组患者的血清CRP、TNF-α、IL-6水平分别为(69.27±21.42)mg/L、(33.47±12.45)pg/m L、(112.73±24.21)pg/m L,明显低于对照组的(101.52±24.12)mg/L、(48.97±14.61)pg/m L、(143.76±27.28)pg/m L,差异均有统计学意义(P<0.05);观察组患者的血浆内毒素及DAO水平分别为(3.25±1.12)EU/m L、(2.98±0.84)ng/L,明显低于对照组的(4.78±1.28)EU/m L、(4.01±1.05)ng/L,差异均有统计学意义(P<0.05)。结论益生菌联合早期肠内营养应用于重症急性胰腺炎患者的治疗,可有效改善肠黏膜屏障功能、降低炎症反应。Objective To investigate the effect of probiotics combined with early enteral nutrition on serum inflammatory factors and intestinal barrier function in patients with severe acute pancreatitis（SAP）. Methods Thirty-four SAP patients were selected in Department of Gastroenterology and ICU of the First Affiliated Hospital of Soochow University during September 2015 to June 2017 as the research objects. According to the random number table, the patients were divided into observation group and control group, with 17 cases in each group. The control group received early enteral nutrition therapy, and the observation group was given Bifid Triple Viable Capsules based on early enteral nutrition therapy. The course of treatment was 14 days. The serum inflammatory factor（C-reactive protein [CRP], tumor necrosis factor-α [TNF-α], interleukelin-6 [IL-6]） and intestinal barrier function index（endotoxin and diamine oxidase [DAO]）changes before and after treatment were compared. Results After treatment, the levels of serum CRP, TNF-α, IL-6 were（69.27±21.42） mg/L,（33.47±12.45） pg/m L,（112.73±24.21） pg/m L, significantly lower than（101.52±24.12） mg/L,（48.97±14.61） pg/m L,（143.76±27.28） pg/m L in the control group（P〈0.05）; plasma endotoxin and DAO levels in observation group was（3.25±1.12） EU/m L,（2.98±0.84） ng/L, significantly lower than（4.78±1.28） EU/m L,（4.01±1.05） ng/L in the control group（P〈0.05）. Conclusion Probiotics combined with early enteral nutrition can effectively improve intestinal mucosal barrier function and reduce inflammatory response in patients with severe acute pancreatitis.

关 键 词：益生菌 肠内营养 重症急性胰腺炎 炎性因子 屏障功能 

分 类 号：R657.51[医药卫生—外科学]