还原型谷胱甘肽联合肠内免疫微生态营养对重症急性胰腺炎患者内毒素及肝功能的影响  

Effects of Reduced Glutathione Combined with Intestinal Immune Microecological Nutrition on Endotoxin and Liver Function of Patients with Severe Acute Pancreatitis

作　　者：葛旭[1] 王国兴[1] 吴迪 GE Xu;WANG Guoxing;WU Di(Department of Emergency,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院急诊科,北京100050

出　　处：《医学综述》2022年第5期1004-1008,共5页Medical Recapitulate

基　　金：国家自然科学基金(81773931)。

摘　　要：目的探讨还原型谷胱甘肽(GSH)联合肠内免疫微生态营养对重症急性胰腺炎(SAP)患者内毒素及肝功能的影响。方法选取2018年5月至2021年4月首都医科大学附属北京友谊医院急诊科收治的SAP患者175例,按照干预方法不同分为对照组(87例)和研究组(88例)。两组患者均给予SAP规范化治疗,对照组在SAP规范化治疗基础上辅以肠内免疫微生态营养治疗;研究组在对照组基础上辅以GSH治疗(1.2 g/d,每日1次),两组均治疗1周。比较两组的临床疗效,治疗前后的内毒素、肝功能指标[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转肽酶(γ-GT)]、炎症因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]、氧化指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]水平,以及并发症发生率。结果研究组总有效率高于对照组[93.18%(82/88)比77.01%(67/87)](χ^(2)=9.043,P=0.003)。治疗后1周,研究组内毒素水平低于对照组[(3.8±1.0)ng/L比(5.2±1.1)ng/L](t=12.153,P<0.001)。治疗前,两组肝功能指标(ALT、AST、γ-GT)、炎症因子(IL-6、CRP、TNF-α)、氧化指标(MDA、SOD)比较差异无统计学意义(P>0.05);治疗后,两组上述指标均低于治疗前,且研究组低于对照组(P<0.01)。两组总并发症发生率比较差异无统计学意义(P>0.05)。结论GSH联合肠内免疫微生态营养治疗SAP患者的临床效果显著,可降低内毒素水平,保护肝脏,且抗炎、抗氧化作用显著,同时具有较好的安全性。Objective To explore the effect of reduced glutathione(GSH)combined with intestinal immune microecological nutrition on the endotoxin and liver function of patients with severe acute pancreatitis(SAP).Methods A total of 175 patients with SAP treated in Department of Emergency,Beijing Friendship Hospital,Capital Medical University from May 2018 to Apr.2021 were included and divided into a control group(87 cases)and a study group(88 cases)according to different intervention methods.Both groups were given SAP standardized treatment.The control group was supplemented with enteral immune microecological nutrition on the basis of SAP standardized treatment,and the study group was supplemented with GSH on the basis of the control group(1.2 g/d,once a day).Both groups were treated for one week.The clinical efficacy,endotoxin,liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-glutamyl transpeptidase(γ-GT)],inflammatory factors[interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)],the oxidation indexes[malondialdehyde(MDA),superoxide dismutase(SOD)]before and after treatment,and the incidence of complications were compared between the two groups.Results The total effective rate in the study group was higher than that in the control group[93.18%(82/88)vs 77.01%(67/87)](χ^(2)=9.043,P=0.003).One week after treatment,the level of endotoxin in the study group was lower than that in the control group[(3.8±1.0)ng/L vs(5.2±1.1)ng/L](t=12.153,P<0.001).Before treatment,the liver function indexes(ALT,AST andγ-GT),inflammatory factors(IL-6,CRP and TNF-α)and oxidation indexes(MDA and SOD)were no significant differences(P>0.05).After treatment,the above indexes in the two groups were lower than those before treatment,and the indexes of the study group were lower than those in the control group(P<0.01).There was no significant difference in the incidence of total complications between the two groups(P>0.05).Conclusion GSH combined with intestinal immune microecological nu

关 键 词：重症急性胰腺炎 肠内营养 还原性谷胱甘肽 肝功能 

分 类 号：R657.5[医药卫生—外科学]