重组人生长激素对重症急性胰腺炎肠黏膜屏障、肠道菌群及炎症因子的影响

Effect of recombinant human growth hormone on intestinal mucosal barrier,intestinal flora and inflammatory factors in patients with severe acute pancreatitis

目的探讨重组人生长激素对重症急性胰腺炎(severe acute pancreatitis,SAP)肠黏膜屏障、肠道菌群及炎症因子的影响。方法选择湖北医药学院附属人民医院2012年6月-2016年2月收治的80例SAP患者作为研究对象,按随机数字表分为观察组(43例)与对照组(37例)。对照组采取常规综合治疗并应用生长抑素粉针剂,观察组在对照组基础上加用重组人生长激素冻干粉针剂。比较两组治疗前后小肠黏膜绒毛高度、陷窝深度、肠杆菌、双歧杆菌、乳酸杆菌、IL-6、IL-8、TNF-α。结果治疗前两组小肠黏膜绒毛高度、陷窝深度、肠杆菌、双歧杆菌、乳酸杆菌、IL-6、IL-8、TNF-α比较,差异无统计学意义(P>0.05);与治疗前相比,对照组治疗后小肠黏膜绒毛高度与陷窝深度差异均无统计学意义(P>0.05),观察组治疗后小肠黏膜绒毛高度及陷窝深度均高于治疗前及对照组治疗后(P<0.05)。治疗后两组肠杆菌数量、IL-6、IL-8、TNF-α降低,双歧杆菌及乳酸杆菌增多(P均<0.05),治疗后观察组肠杆菌数量、IL-6、IL-8、TNF-α低于对照组,双歧杆菌及乳酸杆菌多于对照组(P均<0.05)。结论重组人生长激素在SAP患者中的应用可减轻肠黏膜损伤,修复胃肠道黏膜,调整肠道菌群,抑制早期细胞因子的瀑布效应,下调IL-6、IL-8、TNF-α,抑制炎症进展,从而促进病情缓解。

Objective To invesigate the effect of recombinant human growth hormone on intestinal mucosal barrier, intestinal flora and inflammatory factors in patients with severe acute pancreatitis （SAP）. Methods Eighty patients with SAP who were admitted to the People＇ s Hospital Affiliated to Hubei Medical College from Jun. 2012 to Feb. 2016 were selected as study subjects, and they were divided into observation group （43 cases） and control group （37 cases）. The control group was treated with routine comprehensive therapy and somatostatin powder-injection, and the observation group were additionally treated with recombinant human growth hormone freeze-dried powder injection. The small intesti- nal mucosal villus height, crypt depth, enterobacteria, bacillus bifidus, lactic acid bacillus, IL-6, IL-8 and TNF-α were compared between two groups before and after treatment. Results Before treatment, there was no significant difference in small intestinal mucosal villus height, crypt depth, enterobacteria, bacillus bifidus, lactic acid bacillus, IL-6, IL-8 and TNF-α between two groups （P 〉 0.05） . There was no significant change in small intestinal mucosal villus height and crypt depth in the control group before and after treatment （P 〉 0.05）. The small intestinal mucosal villus height and crypt depth in observation group after the treatment were significantly higher than those in observation group before treatment and the control group after treatment （P 〈 0. 05）. After treatment, the number of enterobacteria, IL-6, IL-8 and TNF-α in the two groups were significantly decreased, bacillus bifidus and lactic acid bacillus were significantly increased （P 〈 0.05）. The number of enterobacteria, IL-6, IL-8 and TNF-α in the observation group were significantly lower than those in the control group, bacillus bifidus and lactic acid bacillus were significantly more than those in the control group （P 〈 0.05）. Conclusion Application of recombinant human growth hormone in patients with SAP can alleviate intestinal mucosa injury, repair gastrointestinal mucosa, adjust intestinal flora, inhibit water fall effect of early cell factor, downgrade IL-6, IL-8 and TNF-α, and inhibit inflammatory process, thus promote remission of disease.