加倍生长抑素联合早期肠内营养对重症急性胰腺炎炎症因子和肠通透性的影响

Effect of double somatostatin and early enteral nutrition on patients with severe acute pancreatitis

目的研究加倍生长抑素(SS)联合早期肠内营养对重症急性胰腺炎炎症因子和肠通透性的影响。方法将60例重症急性胰腺炎患者随机分成三组:SS组、加倍SS组(DSS组)和加倍SS联合早期肠内营养组(DSEN)。在第1、3、6、9天分别检测炎症介质(TNF-α、IL-1)和肠屏障通透性指标(D-乳酸及二胺氧化酶)。结果第3、6天DSS组和DSEN组的TNF-α、IL-1水平低于SS组;第9天DSEN组的TNF-α、IL-1水平低于SS组、DSS组,DSEN组D-乳酸及二胺氧化酶水平低于SS组、DSS组(P<0.05或0.01)。而SS组D-乳酸及二胺氧化酶水平与DSS组比较无统计学差异(P>0.05)。结论加倍SS早期能减少炎症因子生成,同时可能影响肠黏膜的通透性,而联合早期肠内营养能减少肠黏膜的通透性,达到保护肠黏膜屏障的作用。

Objective To investigate the effect of double somatostatin and early enteral nutrition in patients with severe acute pancreatitis.Methods Sixty patients with severe acute pancreatitis were divided into three groups.The patients were treated by either somatostatin（SS）,double somatostatin（DSS） or double somatostatin and early enteral nutrition（DSEN）.The levels of IL-1β,TNF-α,D-lactate and diamine oxidase（DAO） in the peripheral plasma were measured on the first,the third,the sixth,the ninth day.Results The levels of IL-1β and TNF-α in the peripheral plasma in DSS and DSEN group were less than those in SS group on the third,the sixth day.The levels of IL-1β and TNF-α in the peripheral plasma in DSEN group were less than those in DSS and SS group on the ninth day.The levels of D-lactate and DAO in the peripheral plasma in DSEN group were less than those in DSS and SS group on the ninth day.Conclusions Double somatostatin and early enteral nutrition can decrease inflammatory factor and assist in the maintenance of the mucosal barrier function in patients with severe acute pancreatitis.It is considered the most effective method to treat patients with server acute pancreatitis.