摘要
目的探究双歧杆菌三联活菌对体外循环冠状动脉旁路移植术(CABG)患者胃肠功能及炎症水平的影响。方法选取2024年9月至2025年7月于邢台市中心医院行CABG治疗的患者126例,采用随机数字表法将患者分为对照组(n=63)和观察组(n=63),对照组给予患者常规对症治疗,观察组给予患者常规对症治疗+双歧杆菌三联活菌。比较观察组和对照组胃肠功能情况、营养状态(总蛋白、白蛋白、前白蛋白)、D-乳酸水平、白细胞计数及炎症因子(降钙素原、C反应蛋白、白细胞介素6、白细胞介素10)水平。结果观察组首次排气、首次排便以及肠鸣音恢复时间[分别为(28.19±4.36)h、(30.23±5.24)h、(18.13±4.62)h]短于对照组[分别为(34.61±4.71)h、(38.77±5.31)h、(23.14±4.53)h](t=-7.939、-9.086、-6.146,均P<0.05)。观察组胃肠功能障碍发生率11.11%(7/63)低于对照组25.40%(16/63)(χ^(2)=4.308,P<0.05)。观察组血清总蛋白、前白蛋白水平[分别为(77.39±5.88)g/L、(276.94±24.32)mg/L]高于对照组[分别为(69.31±5.78)g/L、(233.84±22.59)mg/L],D-乳酸水平[(0.58±0.15)mmol/L]低于对照组[(0.75±0.18)mmol/L](t=7.778、10.306、-5.789,均P<0.05)。观察组降钙素原、C反应蛋白、白细胞介素6以及血白细胞计数水平[分别为(62.13±10.34)ng/dL、(9.56±2.45)μg/mL、(8.13±2.17)pg/mL、(10.09±1.03)×10^(9)/L]均低于对照组[分别为(66.81±10.51)ng/dL、(11.33±2.36)μg/mL、(11.94±2.35)pg/mL、(11.79±1.00)×10^(9)/L],白细胞介素10水平[(12.07±3.41)pg/mL]高于对照组[(10.49±3.33)pg/mL](t=-2.519、-4.130、-9.454、-9.399、2.631,均P<0.05)。观察组住院时长、肠内营养开始时间[分别为(8.15±1.78)d、(24.17±4.56)h]短于对照组[分别为(11.17±2.47)d、(36.36±6.27)h](t=-7.873、-12.480,均P<0.05),并发症发生率7.94%(5/63)低于对照组25.40%(16/63)(χ^(2)=6.914,P<0.05)。结论双歧杆菌三联活菌能够有效改善CABG患者的胃肠功能和营养状态,降低肠道黏膜屏障的损伤程度以及炎症的反应水平。
Objective To investigate the effects of Bifidobacterium triple viable on gastrointestinal function and inflammation levels in patients undergoing coronary artery bypass grafting(CABG).Methods A total of 126 patients who underwent CABG at Xingtai Central Hospital between September 2024 and July 2025 were prospectively selected and randomly allocated into the control group(n=63)and the observation group(n=63)using a random number table.The control group received conventional symptomatic treatment,while the observation group received conventional treatment plus Bifidobacterium triple viable.Gastrointestinal function,nutritional status(total serum protein,albumin,prealbumin(PAB)),D-lactate level,white blood cell count and inflammatory cytokines(procalcitonin(PCT),C-reactive protein(CRP),interleukin-6(IL-6),interleukin-10(IL-10))levels were compared between the two groups.Results The time to first flatus,first defecation,and bowel sound recovery in the observation group((28.19±4.36)h,(30.23±5.24)h,(18.13±4.62)h,respectively)were shorter than those in the control group((34.61±4.71)h,(38.77±5.31)h,(23.14±4.53)h,respectively)(t=-7.939,-9.086,-6.146,all P<0.05).The incidence of gastrointestinal dysfunction in the observation group was 11.11%(7/63),lower than 25.40%(16/63)in the control group(χ^(2)=4.308,P<0.05).Serum total protein and PAB levels in the observation group((77.39±5.88)g/L,(276.94±24.32)mg/L,respectively)were higher than those in the control group((69.31±5.78)g/L,(233.84±22.59)mg/L,respectively),while the D-lactate level in the observation group((0.58±0.15)mmol/L)was lower than that in the control group((0.75±0.18)mmol/L)(t=7.778,10.306,-5.789,all P<0.05).The levels of PCT,CRP,IL-6,and white blood cell count in the observation group((62.13±10.34)ng/dL,(9.56±2.45)μg/mL,(8.13±2.17)pg/mL,(10.09±1.03)×10^(9)/L,respectively)were lower than those in the control group((66.81±10.51)ng/dL,(11.33±2.36)μg/mL,(11.94±2.35)pg/mL,(11.79±1.00)×10^(9)/L,respectively),while the IL-10 level in the observation group((12.07±3.41)pg/mL)was higher than that in the control group((10.49±3.33)pg/mL)(t=-2.519,-4.130,-9.454,-9.399,2.631,respectively,all P<0.05).The hospital stay and time to initiate of enteral nutrition in the observation group((8.15±1.78)d,(24.17±4.56)h,respectively)were shorter than those in the control group((11.17±2.47)d,(36.36±6.27)h,respectively)(t=-7.873,-12.480,both P<0.05).The incidence of complications in the observation group was 7.94%(5/63),lower than 25.40%(16/63)in the control group(χ^(2)=6.914,P<0.05).Conclusion Bifidobacterium triple viable can effectively improve gastrointestinal function and nutritional status in patients undergoing CABG,reduce damage to the intestinal mucosal barrier,and alleviate inflammatory responses.
作者
赵丽
张驰
祁磊磊
王继宏
郭立新
ZHAO Li;ZHANG Chi;QI Leilei;WANG Jihong;GUO Lixin(Department of Cardiology and Macrovascular Surgery,Xingtai Central Hospital,Xingtai 054000,China;Department ofCataract,Hebei Eye Hospital,Xingtai 054000,China)
出处
《中国药物应用与监测》
2025年第9期1522-1527,共6页
Chinese Journal of Drug Application and Monitoring
基金
邢台市科技计划项目(2024ZC205)。
关键词
双歧杆菌三联活菌
体外循环冠状动脉旁路移植术
胃肠功能
炎症水平
营养状况
Bifidobacterium triple viable
coronary artery bypass grafting
gastrointestinal function
inflammation level
nutritional status
