脾氨肽联合肠道益生菌治疗抗生素相关性腹泻患儿疗效观察

Efficacy of spleen aminopeptide combined with intestinal probiotics on children patients with antibiotic-associated diarrhea

目的:观察脾氨肽联合肠道益生菌对抗生素相关性腹泻(AAD)患儿的治疗效果。方法:选择某院收治的242例AAD患儿按随机数表法分为脾氨肽联合肠道益生菌组(观察组)和肠道益生菌组(对照组),每组各121例。治疗7d后评估疗效,于治疗前(T1)、治疗第3d(T2)及治疗第7d(T3)时观察2组患儿肠道微生态环境变化情况,于T1,T3时检测2组患儿外周血T淋巴细胞亚群(CD4^+,CD8^+,CD4^+/CD8^+,CD3^+)、血清炎症因子[白介素-8(IL-8)、超敏C反应蛋白(hs-CPR)、肿瘤坏死因子-α(TNF-α)]、血清肠黏膜屏障功能指标[二胺氧化酶(DAO)、内毒素脂多糖(LPS)]水平。结果:观察组总有效率优于对照组(P <0. 05); T1～T3时,2组患儿粪便双歧杆菌、乳酸菌水平组间效应、时间点效应及组间与时间点交互效应均有统计学意义(P均<0. 05); T3时,2组患儿外周血CD4^+,CD4^+/CD8^+,CD3^+水平均较T1时升高,且观察组高于对照组(P均<0. 05);外周血CD8^+水平和血清IL-8,hs-CPR,TNF-α,DAO,LPS水平均较T1时降低,且观察组低于对照组(P均<0. 05)。结论:脾氨肽联合肠道益生菌治疗AAD疗效显著,对改善患儿免疫功能、肠道微生态环境和肠道黏膜屏障功能,减轻炎症反应有一定帮助,于病情转归有利。

Objective:To observe the therapeutic effect of spleen aminopeptide combined with intestinal probiotics on children patients with antibiotic-associated diarrhea(AAD).Methods:242 cases of AAD children patients were randomly divided into a spleen aminopeptide+intestinal probiotics group(study group,n=121)and an intestinal probiotics group(control group,n=121).The efficacy was assessed after 7-day's treatment,and the changes of intestinal micro-ecological environment in the two groups were observed before treatment(T1),3d after the treatment(T2)and 7d after the treatment(T3),and the levels of peripheral blood T lymphocyte subsets(CD4^+,CD8^+,CD4^+/CD8^+,CD3^+),serum inflammatory factors[intedeukin-8(IL-8),high-sensitivity C-reactive protein(hs-CPR),tumour necrosis factorα(TNF-α)]and serum intestinal mucosal barrier function indexes[diamine oxidase(DAO),lipopolysaccharide(LPS)]were detected in the two groups at T1 and T3.Results:The total effective rate in the study group was higher than that in the control group(P<0.05).At T1~T3,there were statistically significant differences in between-group effect,time point effect and interaction effect of between-group and time point of faeces bifidobacterium and lactic acid bacteria in the two groups(all P<0.05).At T3,the levels of peripheral blood CD4^+,CD4^+/CD8^+and CD3^+in the two groups were all higher than those at T1,and the levels in the study group were higher than those in the control group(all P<0.05).The levels of peripheral blood CD8^+and serum IL-8,hs-CPR,TNF-α,DAO and LPS were lower than those at T1,and the levels in the study group were lower than those in the control group(all P<0.05).Conclusion:Spleen aminopeptide combined with intestinal probiotics can have significant efficacy on AAD,and may in a way improve the immune function,intestinal micro-ecological environment and intestinal mucosal barrier function,and help to reduce inflammatory response.It is conducive to the prognosis of the disease.