谷氨酰胺联合早期肠内营养治疗重症急性胰腺炎的临床效果及安全性

Clinical effect and safety of glutamine combined with early enteral nutrition in the treatment of severe acute pancreatitis

目的探究谷氨酰胺联合早期肠内营养治疗重症急性胰腺炎(SAP)临床效果及安全性。方法选取2015年12月至2020年12月我院接收的70例SAP患者作为研究对象,按随机数字表法将其分为研究①组和研究②组,各35例。研究①组接受早期肠内营养疗法,研究②组接受谷氨酰胺联合早期肠内营养疗法。比较两组患者的临床病情控制总有效率,白细胞介素-10(IL-10)、白细胞介素-6(IL-6)、免疫球蛋白M(IgM)、肿瘤坏死因子-α(TNF-α)、白蛋白(ALB)水平及急性生理与慢性健康状况Ⅱ(APACHEⅡ)评分。结果治疗14 d后,研究②组的临床病情控制总有效率为94.29%,显著高于研究①组的71.43%,差异具有统计学意义(P<0.05)。治疗14 d后,研究②组IL-10、IgM水平高于研究①组,IL-6、TNF-α水平显著低于研究①组,差异具有统计学意义(P<0.05)。治疗14 d后,两组的ALB水平均显著高于治疗前,且研究②组的ALB水平显著高于研究①组,差异具有统计学意义(P<0.05)。随访12个月后,两组的APACHEⅡ评分均显著低于治疗前,且研究②组的APACHEⅡ评分显著低于研究①组,差异具有统计学意义(P<0.05)。结论谷氨酰胺联合早期肠内营养疗法能够改善SAP患者的炎性因子水平、营养状况、免疫功能,降低APACHEⅡ评分,值得临床推广应用。

Objective To explore the clinical effect and safety of glutamine combined with early enteral nutrition in the treatment of severe acute pancreatitis(SAP).Methods A total of 70 SAP patients received by our hospital from December 2015 to December 2020 were selected as the research objects.The patients were divided into study①group and study②group according to the random number table method,with 35 cases in each group.The study①group received early enteral nutrition therapy,the study②group received glutamine combined with early enteral nutrition therapy.The total effective rate of clinical condition control,interleukin-10(IL-10),interleukin-6(IL-6),immunoglobulin M(IgM)and tumor necrosis factor-α(TNF-α),albumin(ALB)levels and the score of acute physiology and chronic health evaluationⅡ(APACHEⅡ)were compared between the two groups.Results After 14 d of treatment,the total effective rate of clinical condition control in the study②group was 94.29%,which was significantly higher than 71.43%in the study①group,and the difference was statistically significant(P<0.05).After 14 d of treatment,the levels of IL-10 and IgM in the study②group were significantly higher than those in the study①group,and the levels of IL-6 and TNF-αwere significantly lower than those in the study①group,the differences were statistically significant(P<0.05).After 14 d of treatment,the ALB level in the both groups was significantly higher than that before treatment,and the ALB level in the study②group was significantly higher than that in the study①group,the differences were statistically significant(P<0.05).After 12 months of follow-up,the APACHEⅡscore in the both groups was significantly lower than that before treatment,and the APACHEⅡscore in the study②group was significantly lower than that in the study①group,the difference was statistically significant(P<0.05).Conclusion Glutamine combined with early enteral nutrition therapy can improve the levels of inflammatory factors,nutritional status and immune function of SAP patients,and reduce APACHEⅡscore,which is worthy of clinical promotion and application.