微生态制剂联合肠内营养对急性重症胰腺炎患者全身炎症反应、细菌移位以及免疫功能的影响

Influence of probiotics combined with enteral nutrition on Inflammation, bacterial translocation and immune function in severe acute pancreatitis patients

摘要:

目的 探讨微生态制剂联合肠内营养对急性重症胰腺炎（SAP）患者全身炎症反应、细菌移位以及免疫功能的影响。方法 收集该院收治的急性重症胰腺炎患者72 例，随机分为观察组和对照组，每组各36 例。观察组患者接受微生态制剂联合肠内营养，对照组患者仅接受肠内营养，持续2 周。入院时及治疗2 周后，采用流式细胞微球列阵（CBA）测定血清炎症因子水平，采用流式细胞仪检测外周血T 淋巴细胞亚群水平。结果治疗2 周后，观察组血清中白介素2（IL-2）、白介素6（IL-6）、白介素10（IL-10）、内毒素、D- 乳酸的水平低于对照组（P <0.05）；外周血CD3+、CD4+ T 淋巴细胞比例，CD4+/CD8+ 比值高于对照组，CD8+ T 淋巴细胞比例低于对照组（P <0.05）。观察组患者的治疗有效率高于对照组患者（P <0.05）。结论 微生态制剂联合肠内营养可缓解急性重症胰腺炎患者的全身炎症反应，抑制肠道菌群移位，提升机体免疫力，提高近期治疗效果。

Abstract:

Objective To study the influence of probiotics combined with enteral nutrition on Inflammation, bacterial translocation and immune function in severe acute pancreatitis (SAP) patients. Methods Seventy-two cases of SAP patients in our hospital from July 2013 to December 2015 were collected and divided into observation group and control group according to the double blind randomized method, each group had 36 cases in it. Patients in observation group were treated with probiotics combined with enteral nutrition and those in control group were treated enteral nutrition only, each lasted for two weeks. On admission and two weeks after treatment, serum contents of inflammatory cytokines were measured by cytometric bead array (CBA). Results Two weeks after treatment,serum IL-2, IL-6, IL-10, Endotoxin, D-lactate were lower in observation group than those in control group (P < 0.05); peripheral blood CD3+ T lymphocytes, CD4+ T lymphocytes and the ratio of CD4+ /CD8+ were higher in observation group than those in control group, CD8+ T lymphocyte level was lower in observation group than that in control group(P < 0.05). Effective rate of observation group was higher than that of the control group (P < 0.05). Conclusion Probiotics combined with enteral nutrition can relieve systemic inflammatory response ,inhibit intestinal flora translocation, improve the immune function in patients with SAP and improve the short-term treatment effect.