益生菌联合乌司他丁对脓毒症休克患者肠道菌群和胃肠功能及免疫功能的影响

Effects of probiotics combined with Ulinastatin on intestinal flora,gastrointestinal function and immune function in patients with septic shock

目的探讨益生菌联合乌司他丁应用于脓毒症休克患者的效果,为该类患者的治疗提供参考。方法回顾性选取2021年7月至2023年7月我院收治的80例脓毒症休克患者,按治疗方案不同划分组别。入选患者均给予常规基础治疗,其中单一组(38例)患者采用乌司他丁治疗,联合组(42例)患者采用益生菌联合乌司他丁进行治疗。对比两组患者疗效及各指标水平。结果联合组患者治疗后SOFA、APACHEⅡ评分[(5.08±1.07)分、(12.75±2.48)分]均低于单一组[(7.16±1.54)分、(15.66±3.23)分](t=7.707、4.544,均P<0.05)。治疗后,联合组患者肠道乳杆菌与双歧杆菌数量[(5.91±1.02)lg CFU/g、(6.72±1.23)lg CFU/g]高于单一组[(5.24±0.85)lg CFU/g、(5.82±1.06)lg CFU/g],葡萄球菌数量[(3.77±0.32)lg CFU/g]低于单一组[(4.28±0.43)lg CFU/g](t=3.173、6.055、3.488,均P<0.05)。联合组患者治疗后GAS、MOT、IgA、IgG、IgM水平[(67.56±24.82)pg/mL、(408.52±118.47)pg/mL、(2.61±0.43)g/L、(12.24±1.36)g/L、(1.52±0.25)g/L]均优于单一组[(94.30±30.88)pg/mL、(326.39±107.76)pg/mL、(2.18±0.37)g/L、(10.45±1.13)g/L、(1.14±0.22)g/L](t=4.287、3.232、4.770、6.365、7.184,均P<0.05)。结论益生菌联合乌司他丁对于脓毒症休克患者的治疗效果良好,可纠正肠道菌群失调,提升胃肠功能与免疫功能,促进预后改善。

Objective To observe the effect of probiotics combined with Ulinastatin on septic shock patients,providing a reference for the treatment.Methods A total of 80 patients with septic shock diagnosed and treated in our hospital from July 2021 to July 2023 were retrospectively enrolled and divided into different groups according to the treatment plans.All of the patients were given conventional treatment;38 cases in the single drug group were given Ulinastatin and 42 cases in the combination group were given probiotics combined with Ulinastatin.The clinical efficacy and indicator levels were compared between the two groups.Results The SOFA and APACHEⅡscores[(5.08±1.07)score and(12.75±2.48)score]in combination group were lower than those in single drug group[(7.16±1.54)score and(15.66±3.23)score]after treatment(t=7.707,4.544;all P<0.05).After treatment,the counts of intestinal Lactobacillus and Bifidobacterium in combination group[(5.91±1.02)lg CFU/g,(6.72±1.23)lg CFU/g]were higher than those in single drug group[(5.24±0.85)lg CFU/g,(5.82±1.06)lg CFU/g],while that of Staphylococcus[(3.77±0.32)lg CFU/g]was lower than that in single drug group[(4.28±0.43)lg CFU/g](t=3.173,6.055,3.488;all P<0.05).The levels of GAS,MOT,IgA,IgG and IgM after treatment in combination group[(67.56±24.82)pg/mL,(408.52±118.47)pg/mL,(2.61±0.43)g/L,(12.24±1.36)g/L,(1.52±0.25)g/L]were better than those in single drug group[(94.30±30.88)pg/mL,(326.39±107.76)pg/mL,(2.18±0.37)g/L,(10.45±1.13)g/L,(1.14±0.22)g/L](t=4.287,3.232,4.770,6.365,7.184;all P<0.05).Conclusion Probiotics combined with ulinastatin have excellent effects in the treatment of septic shock,which can adjust the imbalance of intestinal flora,enhance gastrointestinal function and immune function,and improve the prognosis.