谷氨酰胺联合早期肠内营养对急性重症胰腺炎患者氨基酸代谢、细菌移位以及炎症反应的影响

Effect of glutamine combined with early enteral nutrition supply on amino acid metabolism,bacterial translocation and inflammatory reaction of acute severe pancreatitis patients

目的:研究谷氨酰胺联合早期肠内营养对急性重症胰腺炎患者氨基酸代谢、细菌移位以及炎症反应的影响。方法:将本院收治的80例急性重症胰腺炎患者纳入研究,根据营养支持治疗方法不同分为两组,观察组接受谷氨酰胺联合早期肠内营养,对照组接受完全肠外营养,比较两组患者的氨基酸代谢、肠道细菌移位以及炎症反应。结果:(1)氨基酸代谢:观察组的血清赖氨酸、苯丙氨酸、甲硫氨酸、苏氨酸、异亮氨酸、亮氨酸、缬氨酸含量高于对照组,差异具有统计学意义(P<0.05);(2)肠道细菌移位:观察患者粪便的双歧杆菌、乳酸杆菌数目高于对照组,大肠杆菌、葡萄球菌、酵母菌数目低于对照组,差异有统计学意义(P<0.05);(3)炎症反应:观察组血清的单核细胞趋化蛋白-1(MCP-1)、人高迁移率族蛋白(HMGB-1)含量低于对照组,差异有统计学意义(P<0.05)。结论:谷氨酰胺联合早期肠内营养治疗有助于预防肠道细菌移位、改善氨基酸代谢、缓解炎症反应,是急性重症胰腺炎理想的支持治疗方法。

Objective： To investigate the effects of glutamine combined with early enteral nutrition supply on amino acid metabolism, bacterial translocation and inflammatory reaction of acute severe pancreatitis patients. Methods： A total of 80 cases of acute severe pancreatitis patients were enrolled and divided into two groups according to different nutrition support treat- ment methods. Observation group received Glutamine combined with early enteral nutrition supply, control group received total parenteral nutrition. Then amino acid metabolism, bacterial translocation and inflammatory reaction were compared. Resuits ： （1） Amino acid metabolism ： serum lysine, phenylalanine, methionine, threonine, isoleucine, leucine, valine of observation were higher than those of control group; （2） Intestinal bacterial translocation： Bifidobacterium, Lactobacillus numbers of observation group were higher than those of control group; number of Escherichia coli, Staphylococcus were lower than those of control group; （3） Inflammatory response： serum MCP-1, HMGB-I content of observation group were lower than those of control group. Conclusion： Glutamine combined with early enteral nutrition therapy is helpful to prevent bacterial translocation, improve amino acids metabolism, relieve inflammation reaction~ it＇s an ideal support treatment method in severe acute panereatitis.