Article Summary
不同肠内营养时机对重症急性胰腺炎患者营养状况、肠黏膜屏障功能及炎症免疫平衡的影响
Effects of Different Enteral Nutrition Timing on Nutritional Status, Intestinal Mucosal Barrier Function and Inflammatory Immune Balance in Patients With Severe Acute Pancreatitis
投稿时间：2024-09-09  修订日期：2024-09-09
DOI：
中文关键词: 肠内营养  重症急性胰腺炎  营养状况  肠黏膜屏障功能  炎症反应  免疫反应
英文关键词: Enteral nutrition  Severe acute pancreatitis  Nutritional status  Intestinal mucosal barrier function  Inflammatory reaction  Immune reaction
基金项目:广东省医学科研基金项目（A2018036）
作者单位邮编
林维茂* 南方医科大学第十附属医院(东莞市人民医院) 523058
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中文摘要:
      目的：探讨重症急性胰腺炎（SAP）患者在不同肠内营养时机干预下，患者肠黏膜屏障功能、营养状况及炎症免疫平衡的改善情况。方法：120例SAP患者根据随机数字表法分为A组、B组、C组，各40例。A组入院后48h内行肠内营养；B组入院后2~5d行肠内营养；C组入院5d后行肠内营养。对比三组营养状况、肠黏膜屏障功能、炎症指标水平、免疫功能及并发症发生率。结果：治疗后，三组血清白蛋白（ALB）、前白蛋白（PA）、转铁蛋白（TRF）水平升高（P＜0.05），A组、B组血清ALB、PA、TRF水平高于C组，且A组高于B组（P＜0.05）。治疗后，三组血清内毒素、二胺氧化酶（DAO）、D-乳酸水平下降（P＜0.05），A组、B组血清内毒素、DAO、D-乳酸水平低于C组，且A组低于B组（P＜0.05）。治疗后，三组血清C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、降钙素原（PCT）水平下降（P＜0.05），A组、B组血清CRP、PCT、TNF-α水平低于C组，且A组低于B组（P＜0.05）。治疗后，三组血清免疫球蛋白A（IgA）、免疫球蛋白G（IgG）、免疫球蛋白M（IgM）水平升高（P＜0.05），A组、B组血清IgA、IgM、IgG水平高于C组，且A组高于B组（P＜0.05）。三组并发症发生率组间对比未见统计学差异（P＞0.05）。结论：在入院后48h内给予SAP患者肠内营养，有利于早期病情的缓解，同时可改善营养状况、肠道功能，减轻炎症免疫反应。
英文摘要:
      Objective:To investigate the improvement of intestinal mucosal barrier function, nutritional status and inflammatory immune balance in patients with severe acute pancreatitis (SAP) under different enteral nutrition timing interventions. Methods:120 patients with SAP were divided into group A, group B and group C according to the random number table method, with 40 cases in each group.Group A received enteral nutrition within 48 hours after admission. group B received enteral nutrition 2~5 days after admission.Group C received enteral nutrition 5 days after admission. The nutritional status, intestinal mucosal barrier function, inflammatory index level, immune function and complication rate in three groups were compared. Results:After treatment, serum albumin (ALB), prealbumin (PA) and transferrin (TRF) levels in three groups increased (P<0.05), serum ALB, PA and TRF levels in group A and group B were higher than those in group C, and those in group A were higher than those in group B (P<0.05). After treatment, serum endotoxin, diamine oxidase (DAO) and D-Lactate levels in three groups decreased (P<0.05), serum endotoxin, DAO and D-Lactate levels in group A and group B were lower than those in group C, and those in group A were lower than those in group B (P<0.05). After treatment, serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and procalcitonin (PCT) levels in three groups decreased (P<0.05), serum CRP, PCT and TNF-α levels in group A and group B were lower than those in group C, and those in group A were lower than those in group B (P<0.05). After treatment, serum immunoglobulin A (IgA), immunoglobulin G (IgG) and immunoglobulin M (IgM) levels in three groups increased (P<0.05), serum IgA, IgM and IgG in group A and group B levels were higher than those in group C,and those in group A were higher than those in group B (P<0.05). There was no significant difference in the complication rate among three groups (P>0.05). Conclusion:Enteral nutrition given to patients with SAP within 48h after admission is conducive to early remission of the disease, while improving nutritional status, intestinal function, and reducing inflammatory immune reaction.
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