微生态免疫营养剂对SAP患者肠道菌群及营养状况的影响  

Effect of Microecological Immunonutrition on Intestinal Flora and Nutritional Status in Patients with SAP

作　　者：任乐宁 李大欢 张国秀[1] 夏征 胡莹莹[1] REN Le-ning;LI Da-huan;ZHANG Guo-xiu;XIA Zheng;HU Ying-ying(Department of Emergency Medicine,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,Henan Province,China;Department of Acupuncture and Massage,Henan Vocational College of Massage,Luoyang 471003,Henan Province,China)

机构地区：[1]河南科技大学第一附属医院急诊医学部,河南洛阳471003 [2]河南推拿职业学院针灸推拿系,河南洛阳471003

出　　处：《罕少疾病杂志》2025年第4期129-131,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的分析微生态免疫营养剂联合谷氨酰胺对重症急性胰腺炎(SAP)患者肠道菌群及营养状况的影响。方法回顾性选取2022年8月至2023年8月医院收治的108例SAP患者临床资料,按随机数字表法分为两组,各54例,两组均连续治疗7d。对照组采取肠内营养+谷氨酰胺治疗,观察组在对照组基础上采取微生态免疫营养剂治疗。于治疗前、治疗7d时比较两组营养指标[白蛋白(ALB)、前白蛋白(PAB)]、肠黏膜屏障指标[细菌内毒素、D-乳酸、二胺氧化酶(DAO)]、肠道菌群变化(双歧杆菌、乳酸杆菌、肠球菌)、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)];比较两组不良反应发生情况。结果治疗7d时,两组ALB、PAB、双歧杆菌、乳酸杆菌、肠球菌水平均高于治疗前,观察组高于对照组(P<0.05);治疗7d时,两组细菌内毒素、D-乳酸、DAO、TNF-α、IL-6、CRP水平均低于治疗前,观察组低于对照组(P<0.05);治疗期间,两组不良反应总发生率均较高(P>0.05)。结论微生态免疫营养剂联合谷氨酰胺可改善SAP患者营养状态,降低肠黏膜屏障损伤,维持肠道菌群稳定,减少炎症反应,具有较高安全性。Objective To analyze the effects of probiotics combined with glutamine on the gut microbiota and nutritional status of patients with severe acute pancreatitis(SAP).Methods Retrospective selection of clinical data from 108 SAP patients admitted to the hospital from August 2022 to August 2023,divided into two groups using a random number table method,with 54 patients in each group,and treated continuously for 7 days in both groups.The control group was treated with enteral nutrition and glutamine,while the observation group was treated with microecological immunonutritional agents on the basis of the control group.Compare two groups of nutritional indicators[albumin(ALB),prealbumin(PAB)],intestinal mucosal barrier indicators[bacterial endotoxins,D-lactate,diamine oxidase(DAO)],changes in gut microbiota(Bifidobacterium,Lactobacillus,Enterococcus),inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)]before and after 7 days of treatment;compare the occurrence of adverse reactions between two groups.Results At 7 days of treatment,the levels of ALB,PAB,Bifidobacterium,Lactobacillus,and Enterococcus in both groups were higher than before treatment,and the observation group was higher than the control group(P<0.05);at 7 days of treatment,the levels of bacterial endotoxins,D-lactate,DAO,TNF-α,IL-6,and CRP in both groups were lower than before treatment,and the observation group was lower than the control group(P<0.05).During the treatment period,the total incidence of adverse reactions in both groups was higher(P>0.05).Conclusion The combination of probiotics and glutamine can improve the nutritional status of SAP patients,reduce intestinal mucosal barrier damage,maintain intestinal microbiota stability,reduce inflammatory reactions,and has high safety.

关 键 词：重症急性胰腺炎 微生态免疫营养剂 谷氨酰胺 肠道菌群 营养状况 

分 类 号：R657.51[医药卫生—外科学]