伊托必利对重症患者营养不良及肠道屏障功能的改善效果评估  

Evaluation of the effect of itopride in improving malnutrition and intestinal barrier function in critically ill patients

作　　者：王启明[1] 刘汉影[1] 陈小云[1] WANG Qi-ming;LIU Han-ying;CHEN Xiao-yun(Zhanjiang Central People's Hospital,Zhanjiang 524000,China)

机构地区：[1]湛江中心人民医院,524000

出　　处：《中国实用医药》2023年第2期24-27,共4页China Practical Medicine

摘　　要：目的探讨伊托必利对重症患者营养不良及肠道屏障功能的改善效果。方法108例重症患者,依据随机数字表法分为对照组和观察组,每组54例。对照组给予常规肠内营养治疗以及益生菌肠内营养干预,观察组在对照组基础上联用伊托必利治疗。比较两组患者不良事件发生情况及治疗前后营养状态[血清总蛋白(TP)、白蛋白(Alb)、血红蛋白(Hb)、微营养评估量表(MNA-SF)评分]、胃肠功能[肠脂肪酸结合蛋白(IFABP)、血管活性肠肽(VIP)]、肠道屏障功能(D-乳酸、二胺氧化酶及细菌内毒素)。结果治疗2周后,两组患者血清TP、Alb、Hb水平以及MNA-SF评分均高于本组治疗前,且观察组患者血清TP、Alb、Hb水平以及MNA-SF评分分别为(65.71±4.12)g/L、(34.37±3.58)g/L、(101.65±6.46)g/L、(12.56±1.25)分,均高于对照组的(61.24±3.97)g/L、(32.46±3.21)g/L、(98.44±7.11)g/L、(11.08±1.69)分,差异具有统计学意义(P<0.05)。治疗2周后,两组患者IFABP低于本组治疗前,VIP高于本组治疗前,且观察组患者IFABP(25.69±5.73)μg/L低于对照组的(32.82±6.01)μg/L,VIP(47.35±5.68)ng/L高于对照组的(41.63±6.23)ng/L,差异具有统计学意义(P<0.05)。治疗2周后,两组患者D-乳酸、二胺氧化酶、细菌内毒素均低于本组治疗前,且观察组患者D-乳酸、二胺氧化酶、细菌内毒素分别为(15.52±4.02)mg/dl、(9.26±2.21)U/L、(14.11±4.67)U/L,均低于对照组的(20.76±5.79)mg/dl、(12.29±3.89)U/L、(16.29±4.83)U/L,差异具有统计学意义(P<0.05)。观察组患者恶心呕吐、感染发生率明显低于对照组,差异具有统计学意义(P<0.05);两组患者腹痛腹泻、食欲减退发生率比较,差异无统计学意义(P>0.05)。结论伊托必利可改善重症患者的营养不良状态,促进肠道屏障功能的恢复,纠正胃肠功能紊乱,降低不良事件发生风险,具有良好的临床应用价值。Objective To discuss the effect of itopride in improving malnutrition and intestinal barrier function in critically ill patients.Methods A total of 108 cases of critically ill patients were divided into control group and observation group according to the random numerical table,with 54 patients in each group.The control group was given conventional enteral nutrition therapy and enteral nutrition with probiotics,while the observation group was treated with itopride on the basis of the control group.Both groups were compared in terms of occurrence of adverse events and nutritional status[total protein(TP),albumin(Alb),hemoglobin(Hb),mini nutritional assessment-short form(MNA-SF)],gastrointestinal function[intestinal fatty acid binding protein(IFABP),vasoactive intestinal peptide(VIP)],intestinal barrier function(D-lactate,diamine oxidase and bacterial endotoxin)before and after treatment.Results After 2 weeks of treatment,the serum TP,Alb,Hb levels and MNA-SF scores of patients in both groups were higher than those before treatment in this group;the serum TP,Alb,Hb levels and MNA-SF scores of patients in the observation group were(65.71±4.12)g/L,(34.37±3.58)g/L,(101.65±6.46)g/L and(12.56±1.25)points,which were higher than(61.24±3.97)g/L,(32.46±3.21)g/L,(98.44±7.11)g/L and(11.08±1.69)points in the control group;the differences were statistically significant(P<0.05).After 2 weeks of treatment,patients in both groups had lower IFABP and higher VIP than those before treatment in this group;the IFABP of patients in the observation group was(25.69±5.73)μg/L,which was lower than(32.82±6.01)μg/L in the control group;the VIP was(47.35±5.68)ng/L in the observation group,which was higher than(41.63±6.23)ng/L in the control group;the differences were statistically significant(P<0.05).After 2 weeks of treatment,the D-lactate,diamine oxidase,and bacterial endotoxin in both groups were lower than those before treatment in this group;the D-lactate,diamine oxidase and bacterial endotoxin of patients in the observation

关 键 词：伊托必利 重症 营养不良 肠道屏障功能 胃肠功能 

分 类 号：R459.3[医药卫生—治疗学]