肠内免疫微生态营养对重症急性胰腺炎患者内毒素、炎症因子及肝损害的影响

目的：观察肠内免疫微生态营养（EIN）对重症急性胰腺炎（SAP）患者内毒素、炎症因子及肝损害的影响。方法：将82例SAP患者随机分为治疗组和对照组,每组41例。两组均给予常规治疗,此外,对照组采用肠外营养（PN）,治疗组采用肠内免疫微生态营养（EIN）。分别在入院时及治疗7d、14d后采血测定肝功能、淀粉酶、内毒素、白介素-8（IL-8）及肿瘤坏死因子-α（TNF-α）等。结果：两组治疗后血淀粉酶、内毒素、IL-8及TNF-α水平均较治疗前明显降低（P〈0.01）,但治疗组较对照组降低更明显（P〈0.01）。治疗组在14d后肝功能各项指标均恢复正常,且与对照组比较,差异有显著统计学意义（P〈0.01）。治疗组感染率及住院时间均显著低于对照组（P〈0.05或P〈0.01）。结论：肠内免疫微生态营养能减轻内毒素血症,降低炎症因子水平,从而减轻SAP患者的肝损害。

Effect of Enteral Ecoimmunonutrition on Endotoxin,Inflammatory Cytokine and Hepatic Injury in Patients with Severe Acute Pancreatitisis

Objective：To observe the effect of enteral ecoimmunonutrition（EIN）on endotoxin,inflammatory cytokine and hepatic injury in patients with severe acute pancreatitis（SAP）.Method：82 patients with SAP were randomly divided into therapy group and control group with each group of 41 cases,both group received conventional treatment,moreover,the control group was given parenteral nutrition（PN）,while the therapy group was given enteral EIN for 14 days. The hepatic function,amylase,endotoxin,interleukin-8（IL-8）and tumor necrosis factor-α（TNF-α）were detected at admission,the seventh,the fourteenth day after treatment.Result：The levels of serum amylase,endotoxin,IL-8 and NF-α in both groups dropped significantly after treatment（P ＆lt;0.01）,they were lower in therapy group than those in the control（P ＆lt;0.01）. The hepatic function in therapy group returned to normal levels after 14 days. The improvement of hepatic function in therapy group was better than the control group（P ＆lt;0.01）. The infection rate and hospital stay in therapy group were lower than those in control group（P ＆lt;0.05 or P ＆lt;0.01）.Conclusion：Enteral EIN can attenuate the levels of plasma endotoxin and inflammatory cytokine,thereby lightening hepatic injury in patients with SAP.