早期益生菌在脓毒症患者治疗中的应用价值

The Application Value of Early Probiotics in the Treatment of Sepsis Patients

目的探讨早期益生菌治疗对脓毒症患者的疗效。方法回顾性分析2019年1月至2023年12月安徽省阜阳市第二人民医院重症医学科(intensive care unit,ICU)收治的100例脓毒症/脓毒症休克患者的临床资料,根据入ICU后3 d内是否益生菌治疗分为益生菌组(55例)和对照组(45例)。比较两组患者益生菌治疗后1周的白细胞计数(white blood cell,WBC)、降钙素原(procalcitonin,PCT)、白介素-6(interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)、血清肌酐(serum creatinine,Scr)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(Aspartate aminotransferase,AST)、总胆红素(total bilirubin,TBiL)和直接胆红素(Direct biliru⁃bin,DBiL),以及急性呼吸窘迫综合症(acute respiratory distress syndromem,ARDS)发生率、菌血症、住ICU时间等预后指标。结果治疗后,益生菌组WBC、PCT、IL-6、CRP、Scr、ALT、AST、TBiL和DBiL均低于对照组,差异有统计学意义(P<0.05)。两组患者ARDS发生率、菌血症、住ICU时间、住院费用等指标间差异有统计学意义(P<0.05)。结论益生菌治疗能够减少脓毒症患者ARDS的发病率,缩短ICU住院时间。

Objective To investigate the effect of early probiotics on patients with sepsis.Methods We conducted a retrospective study of 100 patients with sepsis/septic shock admitted to the intensive care unit(ICU)of the Second People's Hospital of Fuyang City,Anhui Province from January 2019 to December 2023.According to whether probiotic therapy within 3 days after admission to ICU,the patients were divided into 2 groups:patients treated with probiotic(probiotic group,n=55)and patients not treated with probiotic(control group,n=45).The clinical data(such as WBC,PCT,IL-6,CRP,Scr,ALT,AST,TBiL,and DBiL before and 1 week after probiotic treament)and prognostic indicators(such as incidence of acute respiratory distress syndrome(ARDS),bacteremia,ICU stay time,etc.)of two groups of patients were compared.Results After probiotic treatment,WBC,PCT,IL-6,CRP,Scr,ALT,AST,TBiL and DBiL in probiotic group were lower than those in control group,and the difference was statistically significant(P<0.05).There were significant differences in ARDS incidence,bacteremia,ICU stay and hospitalization cost between the two groups(P<0.05).Conclusion Probiotics therapy can reduce the incidence rate of ARDS in patients with sepsis and shorten the length of ICU stay.