乳果糖灌肠辅助治疗对急性胰腺炎患者病情转归及肠黏膜屏障功能的影响

Effect of adjuvant lactulose enema therapy on outcome and intestinal mucosal barrier function in patients with acute pancreatitis

目的:分析乳果糖灌肠辅助治疗对急性胰腺炎患者病情转归以及肠黏膜屏障功能的影响。方法:98例急性胰腺炎患者被随机分为观察组及对照组,对照组接受常规对症治疗,观察组患者接受对症治疗+乳果糖灌肠辅助治疗,对比两组治疗后血清炎性因子、RAAS系统相关分子、黏膜屏障功能相关指标水平,粪便样本中肠道菌群数量等差异。结果:灌肠组血清中炎症因子IL-1β、IL-6、IL-8、PCT、TNF-α的含量显著低于对照组;血清中RAAS系统分子R、AngI、AngⅡ、ALD的含量显著低于对照组(P<0.05);血清中黏膜屏障功能指标D-乳酸、LPS、I-FABP、DAO的含量显著低于对照组(P<0.05);粪便样本中双歧杆菌、乳酸杆菌的数目显著多于对照组,肠杆菌、肠球菌、大肠埃希菌的数量显著低于对照组(P<0.05)。结论:乳果糖灌肠辅助治疗可以促进急性胰腺炎病情好转,恢复患者肠黏膜屏障功能。

Objective：To analyze the effects of adjuvant lactulose enema therapy on outcome and intestinal mucosal barrier function in patients with acute pancreatitis.Methods：A total of 98 patients with acute pancreatitis were randomly divided into observation group and control group,control group received conventional symptomatic treatment,observation group received symptomatic treatment＋ adjuvant lactulose enema therapy,and differences in levels of inflammatory cytokines,RAAS system-related molecules and mucosal barrier function-related indexes in serum as well as intestinal flora quantity in stool samples were compared between two groups after treatment.Results：Serum inflammatory cytokines IL-1β,IL-6,IL-8,PCT and TNF-αlevels of enema group were significantly lower than those of control group;serum RAAS system molecules R,AngI,AngII and ALD levels were significantly lower than those of control group;serum mucosal barrier function indexes D-lactate,LPS,I-FABP and DAO levels were significantly lower than those of control group;the quantity of bifidobacterium and lactobacillus in stool samples were significantly more than those of control group while the quantity of enterobacterium,enterococcus and Escherichia coli were significantly lower than those of control group.Conclusion：Adjuvant lactulose enema therapy can promote the improvement of acute pancreatitis,and restore patients＇ intestinal mucosal barrier function.