早期肠内营养+丙氨酰谷胺酰胺对SAP患者肠道菌群、炎症及氧化反应的影响  

Effects of early enteral nutrition+alanyl-glutamine on intestinal flora,inflammation and oxidative response in patients with SAP

作　　者：朱海龙[1] 王军[1] 张毅[1] 梁夷[1] 吴娟[1] ZHU Hai-long;WANG Jun;ZHANG Yi;Liang Yi;Wu Juan(Department of Critical Care Medicine, the Second People's Hospital of Deyang City Sichuan Province, Deyang, Sichuan Province, 618000)

机构地区：[1]四川省德阳市第二人民医院重症医学科,四川德阳618000

出　　处：《海南医学院学报》2017年第24期3389-3392,共4页Journal of Hainan Medical University

基　　金：德阳重点科学技术研究项目(2016SZ019)~~

摘　　要：目的:探讨早期肠内营养(EEN)+丙氨酰谷胺酰胺对重症急性胰腺炎(SAP)患者肠道菌群、炎症及氧化反应的影响。方法:收集2013年2月~2017年7月间在本院接受治疗的SAP患者90例,根据营养方式不同分为常规EEN组、强化EEN组,各45例。常规EEN组接受早期EEN干预,强化EEN组在早期EEN基础上加入丙氨酰谷胺酰胺干预。对比两组干预前后肠道排泄物中菌群分布,血清中炎症因子及氧化应激指标含量的差异。结果:干预前,两组患者肠道排泄物中菌群分布,血清中炎症因子及氧化应激指标含量的差异无统计学意义(P>0.05)。干预后,强化EEN组肠道排泄物中双歧杆菌、乳酸杆菌计数高于常规EEN组,肠球菌、大肠杆菌计数低于常规EEN组(P<0.05);血清中炎症因子IL-1β、IL-17、IL-23的含量低于常规EEN组(P<0.05);血清中氧化应激指标MPO、XO的含量低于常规EEN组(P<0.05),SOD、CAT的含量高于常规EEN组(P<0.05)。结论:SAP患者接受EEN联合丙氨酰谷胺酰胺治疗,可有效均衡肠道菌群并抑制全身炎症及氧化应激反应。Objective:To investigate the effects of early enteral nutrition+alanyl-glutamine on intestinal flora,inflammation and oxidative response in patients with severe acute pancreatitis(SAP).Methods:90patients with SAP who were treated in the hospital between February2013and July2017were divided into normal EEN group and enhanced EEN group according to different nutritional modes.Normal EEN group received early EEN intervention,and enhanced EEN group received alanyl-glutamine intervention based on early EEN.The differences in the flora distribution in intestinal excreta as well as the contents of inflammatory factors and oxidative stress indexes in serum were compared between the two groups.Results:Before intervention,the differences in the flora distribution in intestinal excreta as well as the contents of inflammatory factors and oxidative stress indexes in serum were not statistically significant between the two groups of patients.After intervention,the bifidobacterium and lactobacillus count in intestinal excreta of enhanced EEN group were higher than those of normal EEN group whereas the enterococcus and escherichia coli count were lower than those of normal EEN group;serum inflammatory cytokines IL-1β,IL-17and IL-23contents were lower than those of normal EEN group;serum oxidative stress indexes MPO and XO contents were lower than those of normal EEN group while SOD and CAT contents were higher than those of normal EEN group.Conclusion:EEN combined with alanyl-glutamine therapy can effectively balance the intestinal flora and inhibit the systemic inflammatory response and oxidative stress response in patients with SAP.

关 键 词：重症急性胰腺炎(SAP) 早期肠内营养 丙氨酰谷胺酰胺 肠道菌群 

分 类 号：R657.51[医药卫生—外科学]