24h内启动添加双歧杆菌的肠内营养对胃十二指肠溃疡穿孔伴腹膜炎术后患者免疫功能、SOD及MDA水平的影响

Effects of enteral nutrition supplemented with ifidobacterium within 24 h on immune function,SOD,and MDA levels in patients with gastroduodenal ulcer perforation with peritonitis after the operation

目的:探讨24 h内启动添加双歧杆菌的肠内营养对胃十二指肠溃疡穿孔伴腹膜炎术后患者免疫功能、超氧化物歧化酶(Superoxide dismutase,SOD)、丙二醛(Malonyldialdehyde,MDA)水平的影响。方法:选取我科2021年2月至2022年6月期间97例胃十二指肠溃疡穿孔伴腹膜炎患者作为研究对象,按计算机分组法分为早期组(n=49)和延期组(n=48),分别于术后24h内或24h后启动肠内营养,干预7d后,分别采用全自动生化分析仪、流式细胞仪、酶联免疫吸附法分别检测对比两组患者白细胞计数(White blood cell,WBC)、C反应蛋白(Creactiveprotein,CRP)、降钙素原(Procalcitonin,PCT)、白介素-6(Interleukin-6,IL-6),T淋巴细胞群CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)等免疫学指标以及SOD、MDA水平。结果:与术前相比,各治疗组的WBC、CRP、PCT、IL-6水平均明显降低(P<0.05),其中早期组更为显著(P<0.05);与术前相比,各治疗组的SOD、MDA水平均明显升高(P<0.05),其中早期组更为显著(P<0.05)。结论:24 h内启动添加双歧杆菌的肠内营养应用于胃十二指肠溃疡穿孔伴腹膜炎术后患者有助于减轻炎症反应,增强免疫功能,改善机体氧化应激反应。

Objective:To investigate the effects of enteral nutrition supplemented with ifidobacterium within 24 hours on immune function,superoxide dismutase,and malondialdehyde levels in patients after gastroduodenal ulcer perforation with peritonitis.Method:A total of 97 patients with gastroduodenal ulcer perforation and peritonitis from February 2021 to June 2022 were selected as research objects in our department,and divided into the early group(n=49)and the delayed group(n=48)according to the computer classification method.Enteral nutrition was initiated within or 24 hours after surgery,and 7 days after the intervention,an automatic biochemical analyzer,flow cytometry,and enzyme-linked immunosorbent assay were used to detect and compare the white blood cell count,C-reactive protein,procalcitonin,interleukin-6,T lymphocyte population CD3^(+),CD4^(+),CD4^(+)/CD8^(+)immunological indexes,as well as the levels of superoxide dismutase and malondialdehyde.Results:Compared with pre-operation,the levels of leukocyte count,C-reactive protein,procalcitonin,and interleukin-6 in all treatment groups were significantly decreased(P<0.05),especially in the early group(P<0.05).Compared with pre-operation,the levels of superoxide dismutase and malondialdehyde in all treatment groups were significantly increased(P<0.05),especially in the early group(P<0.05).Conclusion:The application of enteral nutrition supplemented with ifidobacterium within 24 h in postoperative patients with gastroduodenal ulcer perforation and peritonitis is helpful to reduce inflammation,enhance immune function and improve oxidative stress response of the body.