微生态免疫营养剂对脓毒症肠功能障碍患者炎症反应及免疫功能的影响

Influence of micro-ecological immune nutrient on inflammatory response and immune function of sepsis patients with intestinal dysfunction

目的探讨微生态免疫营养剂用于脓毒症肠功能障碍治疗的效果。方法选取医院2016年1月-2018年1月收治的160例脓毒症肠功能障碍患者,根据随机数表法分为对照组与试验组,每组80例。全部患者均接受常规治疗,试验组在此基础上联合使用微生态免疫营养剂,连续治疗2周。分析两组患者入院、治疗1周、2周后炎症指标、免疫功能指标、肠道菌群(双歧杆菌、乳酸杆菌、葡萄球菌)检出和胃肠道不良反应情况。结果治疗后,两组患者炎症指标CRP、PCT水平均降低,且试验组低于对照组(P<0.05);免疫功能指标CD3+、CD4+、CD4+/CD8+、IgG、IgM、IgA水平均升高,CD8+水平均降低,两组比较差异有统计学意义(P<0.05);试验组双歧杆菌、乳酸杆菌检出数高于对照组,葡萄球菌检出数低于对照组,差异均有统计学意义(P<0.05);试验组胃潴留、腹胀、腹泻、便秘发生率均低于对照组(P<0.05)。结论脓毒症肠功能障碍患者在常规肠内营养治疗基础上联合使用微生态免疫营养剂,有利于减轻患者全身炎症反应,调节其肠道菌群,改善机体免疫功能,减少治疗期间一系列胃肠道不良情况发生,治疗安全有效。

OBJECTIVE To explore the effect of micro-ecological immune nutrient on treatment of the sepsis patients with intestinal dysfunction.METHODS A total of 160 sepsis patients with intestinal dysfunction who were treated in the hospital from Jan 2016 to Jan 2018 were enrolled in the study and randomly divided into the control group and the experimental group,with 80 cases in each group.All of the patients received the conventional therapy,the experimental group was given additional micro-ecological immune nutrient on basis of the conventional therapy for 2 consecutive weeks.The inflammatory indexes,immune function indexes,isolation rates of intestinal flora(Bifidobacterium,Lactobacillus,Staphylococcus)and incidence of gastrointestinal adverse reactions were observed and compared between the two groups of patients at the admission and after the treatment for 1 and 2 weeks.RESULTS The levels of inflammatory indexes CRP and PCT of the two groups of patients were reduced after the treatment,and the levels of above indexes of the experimental group were significantly lower than those of the control group(P<0.05).The levels of immune function indexes CD3+,CD4+,CD4+/CD8+,IgG,IgM and IgA were elevated,the CD8+level was reduced,and there were significantly differences between the two groups(P<0.05).The colony counts of isolated Bifidobacterium and Lactobacillus of the experimental group were greater than those of the control group,the colony counts of isolated Staphylococcus of the experimental group were less than those of the control group,and there were significant differences(P<0.05).The incidence rates of gastric retention,abdominal distension,diarrhea and constipation were significantly lower in the experimental group than in the control group(P<0.05).CONCLUSION The conventional enteral nutrition combined with micro-ecological immune nutrient may alleviate the inflammatory response of the sepsis patients with intestinal dysfunction,regulate the intestinal flora,improve the immune function and reduce the incidence of gastrointestinal adverse reactions,and it is safe and effective for treatment.