益生菌联合肠内营养对急性胰腺炎患者肠道菌群及外周血miR-155的影响

目的探讨益生菌联合肠内营养对急性胰腺炎患者肠道菌群及外周血miR-155的影响。方法选取2016年6月至2018年12月河北医科大学第二医院消化内科收治的92例急性胰腺炎患者作为研究对象,根据随机数字表法分为观察组(n=46)和对照组(n=46),对照组在常规治疗基础上给予肠内营养治疗,观察组在对照组基础上给予双歧杆菌乳杆菌三联活菌片,观察两组患者治疗前后肠道菌群、炎性介质及血清miR-155变化,比较两组患者治疗后胃肠道功能恢复情况。结果治疗后,观察组双歧杆菌、乳酸杆菌增加数量,肠球菌、大肠埃希菌减少数量,血清CRP、IL-6、IL-17、TNF-α、miR-155降低水平均显著高于对照组(P<0.05);观察组患者胃肠生活质量量表(GIQLI)评分高于对照组,腹胀消失时间、腹痛消失时间、肠鸣音恢复时间、血清淀粉酶恢复正常时间均少于对照组(P<0.05)。结论益生菌联合肠内营养治疗急性胰腺炎可调节肠道菌群平衡,降低血清miR-155水平,缓解炎性反应,促进肠道功能恢复。

Effect of probiotics combined with enteral nutrition on intestinal flora and peripheral blood miR-155 in patients with acute pancreatitis

Objective To investigate the effect of probiotics combined with enteral nutrition on intestinal flora and peripheral blood miR-155 in patients with acute pancreatitis.Methods 92 patients with acute pancreatitis admitted to the Department of digestive medicine of our hospital from June 2016 to December 2018 were selected as the study subjects,according to the random number table method,the patients were divided into observation group(n=46)and control group(n=46),the control group was given enteral nutrition treatment on the basis of routine treatment,while the observation group was given Live Combined Bifidobacterium and Lactobacillus Tablets on the basis of the control group,the changes of intestinal flora,inflammatory mediators and serum miR-155 were observed before and after treatment,and the recovery of gastrointestinal function was compared between the two groups.Results After treatment,the number of bifidobacteria and lactobacillus increased and the number of enterococcus and escherichia coli decreased in observation group,and the reduced serum levels of CRP,IL-6,IL-17,TNF-α,and mi5-155 were significantly higher than those of control group(P<0.05).The gastrointestinal quality of life scale(GIQLI)score of patients in observation group was higher than that of control group,and the time for the disappearance of abdominal distension,the time for the disappearance of abdominal pain,the time for the recovery of bowel sounds,and the time for the recovery of serum amylase were all less than that of control group(P<0.05).Conclusion Probiotics combined with enteral nutrition in the treatment of acute pancreatitis can regulate the balance of intestinal flora,reduce the level of serum miR-155,alleviate inflammation and promote the recovery of intestinal function.