摘要
目的 研究肠内与肠外营养对重症急性胰腺炎（SAP）患者肠屏障功能的影响.方法 苏州大学附属第一医院、上海交通大学附属第一医院、无锡市第二人民医院及泰州市人民医院4家单位符合SAP入选标准的63例患者随机分为肠内营养（EN）组及全肠外营养（TPN）组.其中,29例接受EN,经鼻空肠管给予高能肠内营养液;34例接受TPN,通过静脉补充营养液.观察两组患者的血清内毒素、二胺氧化酶（DAO）水平及尿乳果糖/甘露醇（L/M）比值的变化.结果 在第7、14、21天,EN组血清内毒素水平均明显低于TPN组[（39.30±15.82）EU/L比（73.05±21.16）EU/L、（22.64±14.31）EU/L比（49.34±24.54）EU/L、（14.81±10.93）EU/L比（30.08±14.10）EU/L,P值均＜0.05];在第7、14天,EN组的血浆DAO水平均明显低于TPN组[（9.97±3.84）U/L比（19.89±9.89）U/L、（5.42±1.84）U/L比（8.79±4.08）U/L,P值均＜0.05];在第7、14、21天,EN组的尿L/M比值明显低于TPN组（0.28±0.25比0.65±0.45、0.21±0.18比0.54±0.41、0.08±0.04比0.29±0.06,P值均＜0.05）.结论 EN在改善肠屏障功能方面优于TPN.
Objective To evaluate the effect of enteral nutrition （EN） versus total parenteral nutrition（TPN） on gut barrier function in patients with severe acute pancreatitis （SAP）. Methods Sixtythree patients with SAP enrolled from 4 hospitals were randomly assigned into EN group（29 cases） and TPN group（34 cases）. EN group patients were fed via a spiral nasojejunal feeding tube placed routinely by endoscopy or fluoroscopy, and TPN group patients were nourished intravenously with TPN during the same period. The changes of serum endotoxin, diamine oxidase, and urinary excretion of lactulose and mannitol ratio （L/M） were observed. Results Plasma concentration of endotoxin were markedly decreased in EN group as compared with that in TPN group at the 7th,14th ,21th day of entry trial [（39. 30 ± 15. 82） EU/L vs （73.05 ±21.16） EU/L,（22.64 ±14.31） EU/L vs （49.34 ±24.54） EU/L,（14.81 ± 10.93）EU/L vs （ 30. 08 ± 14. 10 ） EU/L, P 〈 0. 05]. Plasma concentration of diamine oxidase were markedly decreased in EN group as compared with that in TPN group at the 7th, 14th day of entry trial [（9. 97 ± 3. 84）U/Lvs （19.89±9.89）U/L,（5.42±1. 84） U/Lvs （8.79 ±4.08） U/L, both P 〈 0. 05]. The urinary L/M decreased significantly in EN group than those in TPN group at the 7th, 14th,21th day of entry trial （0.28 ±0.25 vs 0. 65 ±0.45,0.21 ±0. 18 vs 0.54 ±0.41,0.08 ±0.04 vs 0.29 ±0.06, all P〈0.05）.Conclusion EN has better effect on improving intestinal barrier function than TPN in treatment of patients with SAP.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2011年第5期370-373,共4页
Chinese Journal of Internal Medicine
关键词
肠道营养
胃肠外营养
全
重症急性胰腺炎
肠屏障功能
Enteral nutrition
Parenteral nutrition, total
Severe acute pancreatitis
Gut barrier function
