埃索美拉唑联合早期肠内生态免疫营养对重症急性胰腺炎患者炎症因子和肠黏膜屏障功能的影响

Effect of esomeprazole combined with enteral nutrition on inflammatory factors and intestinal mucosal barrier function in patients with severe acute pancreatitis

目的探讨埃索美拉唑与早期肠内生态免疫营养联合治疗重症急性胰腺炎临床疗效及对患者炎症因子和肠黏膜屏障功能影响。方法98例重症急性胰腺炎患者被随机分为观察组与对照组,各49例。对照组患者采用早期肠内生态免疫营养治疗,观察组患者在对照组基础上结合埃索美拉唑治疗。两组疗程均为2周。比较两组治疗疗效、血淀粉酶和尿淀粉酶恢复正常时间、治疗前后炎症因子和肠黏膜屏障功能影响。结果观察组总有效率高于对照组(χ^2=7.90,P<0.05)。观察组血淀粉酶和尿淀粉酶恢复正常时间快于对照组(t分别=7.09、6.71,P均<0.05)。观察组和对照组治疗后血清肿瘤坏死因子-α(TNF-α)、单核细胞趋化因子蛋白-1(MCP-1)、白介素-6(IL-6)、血清内毒素和D-乳酸水平较治疗前降低(t分别=176.03、19.98、24.28、18.11、16.65;6.38、10.01、11.76、6.85、11.75,P均<0.05);观察组治疗后血清TNF-α、MCP-1、IL-6、血清内毒素和D-乳酸水平低于对照组(t分别=8.21、8.12、15.10、10.32、10.38,P均<0.05)。结论埃索美拉唑与早期肠内生态免疫营养联合治疗重症急性胰腺炎患者临床疗效良好,可减轻炎症反应及改善患者肠黏膜屏障功能。

Objective To investigate the clinical effect of esomeprazole combined with enteral nutrition on severe acute pancreatitis(SAP)patients and its influence on inflammatory factors and intestinal mucosal barrier function.Methods The 98 cases with SAP were randomly divided into observation group(49 cases)and control group(49 cases).The patients in the control group were treated with early enteral eco-immune nutrition,while the patients in the observation group were treated with esomeprazole on the basis of the control group.The course was 2 weeks.The therapeutic effect,the recovery time of blood amylase and urinary amylase,the effects of inflammatory factors and intestinal mucosal barrier function before and after treatment were compared between the two groups.Results The total effective rate of the observation group(91.84%)was higher than that of the control group(69.39%)(χ^2=7.90,P<0.05).The recovery time of blood amylase and urine amylase in the observation group was faster than that in the control group(t=7.09,6.71,P<0.05).After treatment,the levels of serum TNF-α,MCP-1,and IL-6 in the two groups were lower than those before treatment(t=176.03,19.98,24.28,18.11,16.65;6.38,10.01,11.76,6.85,11.75,P<0.05).After treatment,the levels of serum TNF-α,MCP-1,IL-6,endotoxin,and D-lacticin the observation group were lower than those in the control group(t=8.21,8.12,15.10,10.32,10.38,P<0.05).Conclusion Esomeprazole combined with enteral nutrition has a good clinical effect on severe acute pancreatitis,which can reduce inflammatory reaction and improve intestinal mucosal barrier function.