复合乳酸菌胶囊配合营养支持对重症肺炎患者营养生化指标及肠道微生态的影响  

Effect of lactobacillus complex capsules combined with nutritional support on nutritional biochemical indices and intestinal microecology in patients with severe pneumonia

作　　者：徐超 靳莉 张华 XU Chao;JIN Li;ZHANG Hua(Department of Respiratory and Critical Care Medicine,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州大学附属郑州中心医院呼吸与危重症医学科,河南郑州450000

出　　处：《新乡医学院学报》2024年第5期449-454,共6页Journal of Xinxiang Medical University

基　　金：河南省高等学校重点科研项目计划(编号:18A320036)。

摘　　要：目的探讨复合乳酸菌胶囊配合营养支持对重症肺炎患者营养生化指标及肠道微生态的影响。方法选择2017年10月至2019年11月郑州市中心医院收治的117例重症肺炎患者为研究对象。根据治疗方案将患者分为对照组(n=58)和观察组(n=59)。2组患者均给予基础对症治疗,在此基础上,对照组患者给予肠内营养支持,观察组患者给予肠内营养支持和复合乳酸菌胶囊,2组患者均治疗2周。记录2组患者机械通气时间、住院时间、重症监护时间、抗生素使用时间、不良事件发生情况。分别于治疗前、治疗2周后,采用全自动生化分析仪检测2组患者血清白蛋白(ALB)、前白蛋白(PA)水平及淋巴细胞计数(TLC);流式细胞仪测2组患者辅助性T细胞(Th)1、Th2占比,并计算Th1/Th2比值;血气分析仪检测2组患者二氧化碳分压(PaCO_(2))、氧合指数(PaO_(2)/FiO_(2))、血氧饱和度(SaO_(2))。分别于治疗前及治疗2周后,采用急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)评估患者疾病严重程度。分别于治疗前、治疗2周后,取2组患者新鲜粪便检测肠道微生态指标(乳酸杆菌、肠球菌、双歧杆菌计数)。结果观察组患者机械通气时间、住院时间、重症监护时间、抗生素使用时间均显著短于对照组(P<0.05)。治疗前2组患者的PA、TLC、ALB水平比较差异无统计学意义(P>0.05)。2组患者治疗2周后的PA、TLC、ALB水平均显著高于治疗前(P<0.05)。治疗2周后,观察组患者PA、TLC、ALB水平显著高于对照组(P<0.05)。治疗前2组患者PaO_(2)/FiO_(2)、PaCO_(2)、SaO_(2)及APACHEⅡ评分比较差异无统计学意义(P>0.05);2组患者治疗2周后的PaO_(2)/FiO_(2)、SaO_(2)均显著高于治疗前,PaCO_(2)及APACHEⅡ评分均显著低于治疗前(P<0.05);治疗2周后,观察组患者PaO_(2)/FiO_(2)、SaO_(2)显著高于对照组,PaCO_(2)、APACHEⅡ评分显著低于对照组(P<0.05)。治疗前2组患者的Th1、Th2占比及Th1/Th2比值比�Objective To investigate the effect of combined lactobacillus complex capsules and nutritional support on nutritional biochemical indices and intestinal microecology in patients with severe pneumonia.Methods A total of 117 patients with severe pneumonia treated in Zhengzhou Central Hospital from October 2017 to November 2019 were selected as the research subjects.The patients were divided into the control group(n=58)and observation group(n=59)based on their treatment plans.Both groups received basic symptomatic treatment,and on this basis,the control group was given enteral nutritional support,while the observation group was given both enteral nutritional support and lactobacillus complex capsules for two weeks.The duration of mechanical ventilation,hospital stay,length of stay in the intensive care unit,duration of antibiotic use,and incidence of adverse events were recorded and compared between the two groups.The serum albumin(ALB),pre-albumin(PA),and total lymphocyte count(TLC)of patients in the two groups were detected using the fully automatic biochemical analyzer;the proportion of helper T cell(Th)1 and Th2 was detected by flow cytometer,and the Th1/Th2 ratio was calculated;the partial pressure of carbon dioxide(PaCO_(2)),oxygenation index(PaO_(2)/FiO_(2)),and blood oxygen saturation(SaO_(2))were measured using the blood gas analyzer.Before treatment and after two weeks of treatment,the severity of the disease was evaluated using the Acute Physiology and Chronic Health Evaluation II(APACHE II)score,and intestinal microecological indicators(the counts of Lactobacillus,Enterococcus,and Bifidobacterium)were measured.Results The observation group had shorter durations of mechanical ventilation,hospital stay,intensive care unit stay,and antibiotic use compared to the control group(P<0.05).There were no significant differences in the levels of PA,TLC,and ALB between the two groups before treatment(P>0.05).After two weeks of treatment,the levels of PA,TLC,and ALB in both groups increased compared to before treatme

关 键 词：重症肺炎 营养支持 肠内营养 复合乳酸菌胶囊 白蛋白 淋巴细胞计数 肠道微生态 

分 类 号：R563.1[医药卫生—呼吸系统]