微生态制剂对重症急性胰腺炎病人的炎症指标、降钙素原、尿胰蛋白酶原激活肽水平及肠道菌群的影响研究  

Effects of microecologicals on inflammatory index,PCT,TAP levels and intestinal flora of patients with severe acute pancreatitis

作　　者：代宇[1] 叶勇[1] 林影[1] 陈曙蓓 DAI Yu;YE Yong;LIN Ying;CHEN Shubei(Department of Gastroenterology,NeiJiang Second People’s Hospital,NeiJiang,SiChuan 641100,China)

机构地区：[1]内江市第二人民医院消化内科,四川内江641100

出　　处：《安徽医药》2020年第4期826-830,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探究微生态制剂对重症急性胰腺炎(SAP)病人的炎症指标、降钙素原(PCT)、尿胰蛋白酶原激活肽(TAP)水平及肠道菌群的影响,为病人治疗提供临床指导。方法回顾性分析2016年10月至2018年8月在内江市第二人民医院就诊的112例SAP病人的诊疗情况。根据治疗方案不同,分为研究组(60例)和对照组(52例),对照组病人给予肠内营养治疗,研究组病人在肠内营养基础上给予微生态制剂治疗,两组治疗疗程均为7 d。分析比较两组病人临床疗效,比较两组病人治疗前后急性生理与慢性健康评分(APACHEⅡ评分)、炎性因子、PCT、TAP水平及肠道菌群情况。结果研究组临床治疗有效率(88.33%)明显高于对照组(73.08%),差异有统计学意义(P<0.05)。治疗后,两组APACHEⅡ评分均明显降低,且研究组APACHEⅡ评分(7.25±3.49)明显低于对照组(8.92±3.60)(P<0.05)。治疗后,两组病人血清肿瘤坏死因子α(TNF α)、白介素6(IL 6)、白介素8(IL 8)、PCT、TAP水平明显下降(P<0.05),且研究组病人血清TNF α、IL 6、IL 8、PCT、TAP水平明显低于对照组(P<0.05)。治疗后,研究组病人肠道双歧杆菌、乳杆菌计数明显高于对照组(P<0.05),肠杆菌、肠球菌计数明显低于对照组(P<0.05)。结论微生态制剂治疗SAP病人疗效确切,可明显降低病人炎性因子和PCT、TAP水平,调节肠道菌群微生态平衡,值得临床应用。Objective To investigate the effects of microecologicals on inflammatory index,procalcitonin(PCT),urinary trypsino gen activates peptides(TAP)levels and intestinal flora of patients with severe acute pancreatitis(SAP),in order to provide clini cal guidance for the treatment of patients.Methods The clinical data of 112 cases of patients with SAP who received treatment in NeiJiang Second People’s Hospital from October 2016 to August 2018 were retrospective analyzed.Patients were assigned into study group(52 cases)and control group(60 cases)according to different treatment methods.Patients in the control group were treated with enteral nutrition therapy,while patients in the study group were treated with microecologicals on the basis of enteral nu trition therapy.The treatment duration of both groups was 7 d.The clinical curative effect,the acute physiology and chronic health evaluationⅡscore(APACHEⅡscore),inflammatory factors,PCT and TAP levels,intestinal flora before and after treatment in the two groups were analyzed and compared.Results The clinical treatment efficiency of the study group(88.33%)was signifi cantly higher than 73.08%of the control group,the difference with statistical significance(P<0.05).After treatment,the APACHEⅡscore of the study group and the control group were significantly lower than before treatment(P<0.05),and APACHEⅡscore of the study group(7.25±3.49)was significantly lower than(8.92±3.60)of the control group,the difference with statistical signifi cance(P<0.05).After treatment,the levels of serum tumor necrosis factorα(TNF α),interleukin 6(IL 6),interleukin 8(IL 8),PCT,TAP of the two groups were both lower than those before treatment(P<0.05),and the levels of the TNF α,IL 6,IL 8,PCT,TAP of the study group were lower than those of the control group(P<0.05).After treatment,the intestinal bifidobacteria and lacto bacillus count of the study group were significantly higher than those of the control group(P<0.05),and enterobacter and entero coccus count of the study group wer

关 键 词：胰腺炎 急性坏死性 肠道营养 肿瘤坏死因子α 白细胞介素6 白细胞介素8 肠杆菌属 肠球菌属 微生态制剂 降钙素原 尿胰蛋白酶原激活肽 肠道菌群 

分 类 号：R576[医药卫生—消化系统]