微生态免疫营养剂联合血液净化对脓毒症患者肠道菌群的影响  

Effect of microecological immune nutrition combined with blood purification on regulating efficacy and intestinal flora in patients with sepsis

作　　者：杨春波[1] 李建[1] 李岩[1] 柴瑞峰[1] 于朝霞[1] YANG Chun-bo;LI Jian;LI Yan;CHAI Rui-feng;YU Zhao-xia(Department of Critical Medicine,the First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830000,China;不详)

机构地区：[1]新疆医科大学第一附属医院重症医学科,新疆乌鲁木齐830000

出　　处：《中国微生态学杂志》2023年第3期335-338,343,共5页Chinese Journal of Microecology

基　　金：新疆维吾尔自治区自然科学基金资助项目(2021D01C305)。

摘　　要：目的研究微生态免疫营养剂(microecological immune nutrients,MIN)联合血液净化对脓毒症患者肠道菌群的影响。方法选择2020年1月至2022年1月我院收治的120例脓毒症患者,使用随机数表法分为对照组和观察组,每组各60例,对照组患者应用血液净化治疗,观察组应用MIN联合血液净化治疗。分析两组患者治疗前后SOFA评分、APACHEⅡ评分、炎症指标水平、免疫功能变化、肠道菌群变化,分析胃肠道不良反应发生率。结果治疗后两组患者SOFA和APACHEⅡ评分均显著降低,其中观察组患者SOFA和APACHEⅡ评分显著低于对照组(均P<0.05)。治疗后两组患者C反应蛋白(CRP)及降钙素原(PCT)水平均显著降低,其中观察组患者CRP和PCT水平显著低于对照组(均P<0.05)。治疗后两组患者IgG、IgM和IgA水平均显著改善,且观察组患者治疗后IgG、IgM和IgA水平均高于对照组(均P<0.05)。观察组患者胃肠道不良反应发生率显著低于对照组(P<0.05)。两组患者肠道双歧杆菌、乳杆菌检出数量均较入院时升高,葡萄球菌检出数量减少,观察组升高或减少幅度均高于对照组(均P<0.05)。结论MIN联合血液净化治疗脓毒症患者可有效改善患者SOFA和APACHEⅡ评分,提高免疫因子水平,降低不良反应的发生率,改善患者肠道微生态。Objective To analyze the effect of microecological immune nutrient(MIN)combined with blood purification on intestinal flora in patients with sepsis.Methods A total of 120 patients with sepsis treated in our hospital from January 2020 to January 2022 were randomly divided into control group and observation group,with 60 cases in each group.The control group was treated with blood purification,and the observation group was treated with MIN and blood purification.The scores of SOFA and APACHEⅡ,inflammatory indexes levels,changes of intestinal flora and changes of immune function were analyzed.Incidence of gastrointestinal adverse reactions were observed.Results After treatment,the scores of SOFA and APACHEⅡin both groups decreased significantly.The scores of SOFA and APACHEⅡ,and the levels of CRP and PCT in observation group were significantly lower than those in the control group respectively(all P<0.05).After treatment,the levels of IgG,IgM and IgA in both groups were significantly improved,and those in observation group were significantly higher than those in the control group(all P<0.05).The incidence of gastrointestinal adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).The counts of intestinal Bifidobacteria and Lactobacillus were higher than those at admission,while the count of Staphylococcus was lower(all P<0.05).Conclusion MIN combined with blood purification in the treatment of patients with sepsis can effectively improve the scores of SOFA and APACHEⅡ,improve the levels of immune factors,reduce the occurrence of adverse reactions,and improve the intestinal microecology in patients.

关 键 词：微生态免疫营养剂 血液净化 脓毒症 肠道微生态 

分 类 号：R453[医药卫生—治疗学]