果胶对老年卒中患者肠道屏障功能的影响  

Effect of pectin on intestinal barrier function in elderly stroke patients

作　　者：侯斌[1] 年崇文 濮雪华[1] 朱尚 周田甜 王霞 叶纪录[1] Hou Bin;Nian Chongwen;Pu Xuehua;Zhu Shang;Zhou Tiantian;Wang Xia;Ye Jilu(Department of Critical Care Medicine,Taizhou People’s Hospital,Taizhou,225300,China;Department of Clinical Medicine,Dalian Medical University,Dalian,1160000,China)

机构地区：[1]泰州市人民医院重症医学科,泰州225300 [2]大连医科大学研究生院,大连116000

出　　处：《中华急诊医学杂志》2022年第10期1402-1406,共5页Chinese Journal of Emergency Medicine

基　　金：真实世界研究专项基金临床科研资助项目(ZC-2019-ICU-057);泰州市社会发展基金(TS201931)。

摘　　要：目的探究果胶对改善老年卒中患者肠道屏障损伤的作用。方法纳入2020年11月至2021年10月泰州市人民医院重症医学科行肠内营养的老年卒中患者共60例。其中30例为对照组,使用常规肠内营养液;另外30例为研究组,在常规肠内营养液基础上添加果胶。在肠内营养的第1天、第7天检测血清二胺氧化酶(DAO)、D-乳酸(D-LA)水平,以评估老年卒中患者肠道屏障功能;检测两组患者血清炎症相关指标白细胞介素-6(IL-6)、降钙素原(PCT)和超敏C反应蛋白(CRP),评估老年卒中患者的炎症反应水平。并比较两组患者的临床预后。结果两组患者应用肠内营养的第7天,与对照组相比,研究组DAO数值[(4.05±1.56)ng/mL]、D-LA数值[(6.11±2.20)mmol/L]均明显下降(均P<0.05)。且研究组炎症指标IL-6[(15.43±12.53)pg/mL]、PCT[(0.82±0.98)ng/mL]、CRP[(6.94±6.60)mg/L]均低于对照组,两组相比差异有统计学意义(均P<0.05)。研究组患者住ICU时间和总住院时间较对照组缩短(P<0.05),但两者在卒中相关肺炎发生率(16.7%vs.30%)和30 d病死率(13.3%vs.20%)差异无统计学意义(均P>0.05)。结论与常规肠内营养相比,添加果胶的肠内营养可以改善老年卒中患者肠屏障功能;添加果胶的肠内营养能降低老年卒中患者的炎症反应。Objective To explore the effect of pectin on improving intestinal barrier injury in elderly stroke patients.Methods A total of 60 elderly stroke patients who received enteral nutrition in Department of Critical Care Medicine of Taizhou People's Hospital from November 2020 to October 2021 were included.The control group included 30 cases,using conventional enteral nutrition solution.The other 30 cases were in the study group,and pectin was added on the basis of routine enteral nutrition solution.The levels of serum diamine oxidase(DAO)and D-lactic acid(D-LA)were measured on the fi rst and 7th days of enteral nutrition to evaluate the intestinal barrier function of elderly stroke patients.The levels of interleukin-6(IL-6),procalcitonin(PCT)and high-sensitivity C-reactive protein(CRP)were measured to evaluate the infl ammatory response level of elderly stroke patients.The clinical prognosis of the two groups was compared.Results Compared with the control group,the values of DAO[(4.05±1.56)ng/mL]and D-LA[(6.11±2.20)µmol/L]in the study group were significantly lower than those in the control group on the 7th day(all P<0.05).Also the levels of IL-6[(15.43±12.53)ng/mL],PCT[(0.82±0.98)ng/mL]and CRP[(6.94±6.60)mg/L]in the study group were lower than those in the control group,and the difference between the two groups was statistically signifi cant(all P<0.05).Compared with the control group,the length of ICU stay and total length of hospital stay in the study group were shorter than those in the control group(P<0.05),but there was no signifi cant difference in the incidence of stroke-related pneumonia(16.7%vs.30%)and 30-day mortality(16.7%vs.20%)between the two groups(P>0.05).Conclusions The enteral nutrition with pectin supplementation can improve intestinal barrier function and reduce infl ammatory response in elderly stroke patients.

关 键 词：脑卒中 果胶 肠道屏障 二胺氧化酶 D-乳酸 

分 类 号：R743.3[医药卫生—神经病学与精神病学]