益生菌治疗重症急性胰腺炎的研究现状

Probiotics in treatment of severe acute pancreatitis

重症急性胰腺炎(severe acute pancreatitis,SAP)病情凶险,病死率高,严重威胁患者的生命安全.感染和菌血症是SAP患者主要的死因.预防性应用抗生素并不能减少SAP患者感染性并发症的发生率,因此世界卫生组织(World Health Organization,WHO)提倡益生菌治疗.益生菌通过促进肠道动力、抑制肠道致病菌过度生长、保护肠黏膜的屏障功能、调节肠道免疫功能及减轻胰腺、肺、肝损伤来改善SAP患者的预后.近年研究表明益生菌联合免疫营养能改善SAP患者的预后.目前,益生菌应用于SAP还存有争议.

Severe acute pancreatitis （SAP） is a life-threat- ening condition characterized by high mortal- ity, with infection and bacteremia being major causes of death. Prophylactic antibiotic admin- istration failed to show any favorable effect on the incidence of infectious complications in SAP patients. Consequently, microorganism interven- tion is recommend by World Health Organiza- tion （WHO）. Probiotics improve the prognosis of SAP patients by promoting gastrointestinal peristalsis, modulating the content of gut micro- biota, maintaining the integrity of the gut barrier, modulating the immune response by the gut-as- sociated immune system and reducing the dam- age to the pancreas, lung and liver. It has been demonstrated that probiotics in combination with immunonutrition could improve the prognosis of SAP patients. However, the use of probiotics in SAP remains controversial currently.