重症急性胰腺炎继发脓毒症患者肠道细菌易位特征观察  

Observation on the characteristics of intestinal bacterial translocation in patients with acute and severe pancreatitis secondary to sepsis

作　　者：朱剑[1] 罗祖金[1] 赵娜[1] 刘霁尘 曹志新[1] 陈云凤 ZHU Jian;LUO Zu-jin;ZHAO Na;LIU Ji-chen;CAO Zhi-xin;CHENYun-feng(Beijing Chaoyang Hospital Affiliated to Capital Medical University,Department of Respiratory and Critical Care Medicine,100043,China)

机构地区：[1]首都医科大学附属北京朝阳医院呼吸与危重症医学科

出　　处：《现代消化及介入诊疗》2019年第6期593-596,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

摘　　要：目的研究重症急性胰腺炎继发脓毒症患者肠道细菌易位特征。方法选取首都医科大学附属北京朝阳医院2016年2月至2017年2月收治的62例重症急性胰腺炎继发脓毒症患者纳入研究对象,设为A组(脓毒症组),另外选取同期收治的58例重症急性胰腺炎患者纳入研究对象,设为B组(非脓毒症组)。两组患者均在入院后取胰腺周围渗液行细菌培养,并对细菌培养结果进行分析,另外对比两组降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、Fas、sFas、淋巴细胞凋亡等指标差异。结果A组共计培养出细菌126株,其中革兰阴性菌82.54%(104/126),革兰阳性菌17.46%(22/126);B组共计培养出细菌108株,其中革兰阴性菌80.56%(87/108),革兰阳性菌19.44%(21/108)。A组PCT、CRP、IL-2、IL-6、IL-1β水平显著高于B组,差异有统计学意义(P<0.05)。A组Fas、sFas、淋巴细胞凋亡各项指标显著高于B组,差异有统计学意义(P<0.05)。结论重症急性胰腺炎患者可因炎症因子高表达、免疫抑制、肠屏障功能障碍出现肠道细菌易位,并继发脓毒症。Objective To study the characteristics of intestinal bacterial translocation in patients with acute and severe pancreatitis secondary to sepsis. Methods 62 patients with acute and severe pancreatitis and secondary sepsis admitted and treated in our hospital from February2016 to February2017 were included in the research object, which was set as group A (sepsis group).In addition, 58 cases of acute and severe pancreatitis admitted during the same period were included in the study, which were set as group B (non-sepsis group).All the patients in the two groups were taken from the peritancreatic effusion before admission for bacterial culture, and the bacterial culture results were analyzed. In addition, the differences in various indicators of PC, CRP, IL-2, IL-6, IL-1, Fas, sFas and lymphocyte apoptosis in the two groups were compared. Results A total of126 strains of bacteria were cultured in group A, among which 82.54%(104/126) were gram-negative and17.46%(22/126) were gram- positive. A total of108 bacterial strains were cultured in group B, of which 80.56%(87/108) were gram-negative and 19.44%(21/108) were gram-positive.The levels of PCT, CRP, IL-2, IL-6 and IL-1β in group A were significantly higher than those in group B ( P <0.05).The indexes of Fas, sFas and lymphocyte apoptosis in group A were significantly higher than those in group B ( P <0.05). Conclusion In patients with acute and severe pancreatitis, intestinal bacterial translocation may occur due to high expression of inflammatory factors, immunosuppression, and intestinal barrier dysfunction, and secondary sepsis may occur.

关 键 词：肠道细菌易位 重症急性胰腺炎 脓毒症 炎症 免疫 

分 类 号：R576[医药卫生—消化系统]