益生菌对重症感染性肺炎患儿血糖的稳定作用及其机制研究

Analysis of probiotics on stabilization of blood glucose in children with severe infection pneumonia and its mechanism

目的研究益生菌对重症感染性肺炎患儿血糖的稳定作用及其机制。方法选取2016年9月-2017年9月于医院进行治疗的98例重症感染性肺炎患儿,根据数字表法随机分为对照组和试验组,每组49例患儿。对照组患儿给予常规治疗,试验组患儿采用益生菌治疗。对比两组患儿治疗前后血糖、血浆硫化氢(H2S)、D-乳酸水平以及粪便短链脂肪酸;观察血糖浓度与血浆H2S、D-乳酸及乙酸的相关性。结果治疗后,试验组患儿血糖(6.08±2.66)mmol/L、D-乳酸水平(1.24±0.38)μg/ml低于对照组血糖(8.40±2.67)mmol/L、D-乳酸水平(1.46±0.41)μg/ml,而H2S水平(24.68±7.42)μmol/L则高于对照组(20.89±7.37)μmol/L(P<0.05);试验组患儿丙酸(21.07±5.27)μmol/g、乙酸(32.84±8.56)μmol/g、正丁酸水平(15.27±5.18)μmol/g,高于对照组丙酸(18.68±5.13)μmol/g、乙酸(28.59±7.87)μmol/g、正丁酸水平(12.89±5.02)μmol/g(P<0.05);血糖浓度与血浆H2S、D-乳酸及乙酸具有相关性,与D-乳酸水平呈正相关性,血糖浓度与血浆H2S和乙酸水平呈负相关(P<0.05)。结论益生菌对重症感染性肺炎患儿病情的发展与恶化能够起到良好的控制作用,合理应用益生菌后,患儿血糖、血浆H2S、D-乳酸水平、丙酸、乙酸、正丁酸等粪便短链脂肪酸指标情况趋于正常,接近于正常水平,该方法安全、有效,临床上可推广应用。

OBJECTIVE To study the effect of probiotics on stability of blood glucose in children with severe infection pneumonia and its mechanism.METHODS A total of 98 children with severe infectious pneumonia who were treated in our hospital from Sep.2016 to Sep.2017 were randomly divided into the control group and the observation group according to the digital table method,with 49 cases in each group.The children in the control group were treated with routine treatment,and the children in the observation group were treated with probiotics.The blood glucose,plasma H2 S,D-lactic acid levels and stool short chain fatty acids before and after treatment were compared between the two groups.The correlation between plasma glucose and plasma H2 S,D-lactic acid and acetic acid was observed.RESULTS After treatment,the blood glucose was(6.08±2.66)mmol/L and the D-lactic acid level was(1.24±0.38)g/ml in the observation group,significantly lower than those of the control group[(8.40±2.67)mmol/L,and(1.46±0.41)g/ml,respectively],whereas the H2 S level was(24.68±7.42)mol/L in the observation group,which was significantly higher than that of the control group[(20.89±7.37)mol/L].The differences(P<0.05).The propionic acid level was(21.07±5.27)mol/g,acetic acid was(32.84±8.56)mol/g,butyric acid was(15.27±5.18)mol/g in the observation group,significantly higher than those of the control group[(18.68±5.13)mol/g,(28.59±7.87)mol/g,and(12.89±5.02)mol/g,respectively](P<0.05).The blood glucose concentration was correlated with plasma H2 S,D-lactic acid and acetic acid,and showed a significant positive correlation with D-lactic acid(P<0.05).Blood glucose concentration was negatively correlated with plasma H2 S and acetic acid(P<0.05).CONCLUSIONProbiotics can play agood control effect on the development and deterioration of disease in children with severe infectious pneumonia.After reasonable application of probiotics,the blood glucose,plasma H2 S,D-lactic acid,acetic acid,propionic acid,butyric acid and fecal short chain fatty acid index all tended to be normal or close to the normal level.This method is safe and effective,and is worthy of clinical application.