重症急性胰腺炎患者肠道菌群、肠道屏障功能变化及益生菌的干预效果

The changes of intestinal microflora and intestinal epithelial barrier in patients with severe acute pancreatitis and the effect of probiotics

目的：研究重症胰腺炎患者肠道菌群、肠道黏膜屏障的变化及肠道益生菌的干预效果。方法选择重症胰腺炎患者36例为研究对象，采用数字表法随机分为观察组和对照组，各18例。对照组给予重症胰腺炎的常规治疗，观察组在胰腺炎常规治疗的基础上给予肠道益生菌。观察胰腺炎对肠道菌群的影响及益生菌的干预作用。结果治疗后，观察组双歧杆菌、乳酸杆菌含量分别为（6．54±1．78）ln／g、（7．36±1．58）ln／g，明显高于对照组[（4．35±1．12）ln／g、（4．38±1．29）ln／g]（t ＝3．78、4．15，P ＜0．05）；而大肠杆菌、肠球菌含量分别为（7．86±1．98）ln／g、（5．21±0．96）ln／g，低于对照组的（8．96±1．87）ln／g、（6．65±1．78）ln／g，差异均有统计学意义（t ＝3．65、3．67，均 P ＜0．05）。治疗后，观察组内毒素、血浆二胺氧化酶（DAO）、D-乳糖水平分别为（20．54±6．37）pg／mL、（4．38±1．20）U ／mL、（6．36±1．64）mg／L，均明显低于对照组的（50．97±9．94）pg／mL、（5．89±1．29）U ／mL、（9．17±1．97）mg／L（t ＝3．46、3．14、4．06，均 P ＜0．05）。观察组有效率为94．4％，高于对照组的88．8％，两组差异有统计学意义（χ2＝4．15，P ＜0．05）。结论肠道益生菌有助于改善重症胰腺炎患者肠道菌群和肠道黏膜功能，值得临床推广运用。

Objective To study the changes of intestinal microflora and intestinal epithelial barrier in patients with severe acute pancreatitis and the effect of probiotics.Methods 36 cases of severe acute pancreatitis were selected as the research subjects.They were randomly divided into observation group and control group.18 cases in the control group were given the conventional treatment for severe acute pancreatitis,the observation group was given intestinal probiotics based on routine treatment for pancreatitis.The effect of pancreatitis on intestinal flora and the intervention effect of probiotics were observed.Results After treatment,the contents of Bifidobacterium and lactobacillus in the observation group were （6.54 ±1.78）,ln/g（7.36 ±1.58）ln/g,which were significantly higher than those in the control group[（4.35 ±1.12）,ln/g（4.38 ±1.29）ln/g]（t =3.78,4.15,all P 〈0.05）;and Esche-richia coli and Enterococcus contents were （7.86 ±1.98）,ln/g（5.21 ±0.96）ln/g,which were lower than those of the control group [（8.96 ±1.87）ln/g,（6.65 ±1.78）ln/g],the differences were statistically significant（t =3.65, 3.67,all P 〈0.05）.After treatment,the levels of plasma endotoxin,diamine oxidase（DAO）,D -lactose of the obser-vation group were （20.54 ±6.37）pg/mL,（4.38 ±1.20）U /mL,（6.36 ±1.64）mg/L,which were significantly lower than those of the control group [（50.97 ±9.94）pg/mL,（5.89 ±1.29）U /mL,（9.17 ±1.97）mg/L]（t =3.46, 3.14,4.06,all P 〈0.05）.The effective rate of the observation group was 94.4%,which was higher than 88.8% of the control group,there was significant difference between the two groups（χ2 =4.15,P 〈0.05）.Conclusion The intestinal probiotics can help to improve the intestinal microflora and intestinal epithelial barrier in patients with severe acute pancreatitis,it is worthy of clinical application.