益生菌联合谷氨酰胺对急性重症胰腺炎患者肠黏膜屏障功能的影响  

Influence of probiotics combined with glutamine on intestinal mucosal barrier function in patients with acute severe pancreatitis

作　　者：张剑[1] 朱林[2] 李文尧[1] 宋毅[1] ZHANG Jian;ZHU Lin;LI Wen-yao;SONG Yi(Department of Clinical Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China;Department of Integrated Traditional Chinese and Western Medicine,West China Hospital,Sichuan University, Chengdu 610041, China)

机构地区：[1]四川大学华西医院临床药学部,四川成都610041 [2]四川大学华西医院中西医结合科,四川成都610041

出　　处：《中国中西医结合消化杂志》2018年第3期293-296,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：[目的]分析益生菌联合谷氨酰胺(Gln)对急性重症胰腺炎(SAP)患者肠黏膜屏障功能的影响。[方法]选取SAP患者78例,随机分为观察组与对照组,各39例。2组均予以加用Gln的肠内营养治疗,观察组在此基础上加用四联益生菌制剂,观察治疗第1、7、14、21天2组急性生理与慢性健康Ⅱ(APACHE-Ⅱ)评分、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、内毒素、D-乳酸及二胺氧化酶(DAO)水平的变化。[结果]2组治疗第7天APACHE-Ⅱ评分与治疗第1天比较无明显变化(P>0.05),但治疗第14、21天明显降低(P<0.01),其中观察组降低程度更为显著(P<0.05)。治疗第7、14、21天,2组CRP、TNF-α水平及内毒素、D-乳酸、DAO水平均较治疗第1天明显降低(P<0.05或P<0.01),但观察组治疗第14、21天上述各水平均显著低于对照组,差异有统计学意义(P<0.05)。[结论]益生菌联合Gln的肠内营养能有效缓解SAP患者的机体炎症反应,减轻内毒素血症,减少肠道细菌移位,从而利于肠黏膜屏障功能的恢复。[Objective]To analyze the influence of probiotics combined with glutamine（Gln）on intestinal mucosal barrier function in patients with acute severe pancreatitis（SAP）.[Methods]A total of 78 patients with SAP were selected and randomly divided into observation group and control group,39 cases for each group.Both groups received enteral nutrition（EN）containing Gln,on which basis observation group was added with Tetragenous probiotics inhibitor.The changes of Acute Physiology and Chronic Health Evaluation（APACHE II）scores and the levels of C-reactive protein（CRP）,tumor necrosis factor-α（TNF-α）,endotoxin,D-lactic acid and diamine oxidase（DAO）.[Results]There was insignificant change in APACHE II scores in both groups on d7 after treatment than those on d1（P〈0.05）,but decreased notably on d14 and d21 after treatment（P〈0.01）,which decreased more significantly in observation group than that in control group（P〈0.05）.The levels of CRP,TNF-α,endotoxin,D-lactic acid and DAO decreased prominently in both groups on d7,14 and 21 after treatment than those on d1（P〈0.05 or P〈0.01）,which were apparently lower in observation group than those in control group on d14 and 21 after treatment（P〈0.05）.[Conclusion]EN of probiotics combined with Gln can effectively relieve the inflammatory responses,and endotoxaemia,and reduce bactrial translocation in intestinal tract,so as to assist the recovery of intestinal muco-sal barrier function in patients with acute SAP.

关 键 词：急性重症胰腺炎 益生菌 谷氨酰胺 肠黏膜屏障 肠内营养 

分 类 号：R576[医药卫生—消化系统]