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目的:研究乳果糖联合生长抑素治疗对急性胰腺炎患者炎症介质、肠道菌群、Fas/FasL表达量的影响。方法:将2013年5月~2015年10月在本院就诊的56例急性胰腺炎患者随机分为A组和B组,A组患者给予乳果糖、生长抑素联合常规治疗,B组患者给予生长抑素联合常规治疗。治疗3d后,测定血清中炎症介质、sFas、sFasL的含量以及外周血中Fas、FasL的表达量以及粪便组织中肠道菌群的拷贝数。结果:治疗3d后,A组患者血清中IL-1β、IL-6、IL-8、IL-10、IL-18、sFas、sFasL的含量显著低于B组,外周血中Fas、FasL的mRNA含量和蛋白含量显著低于B组,粪便组织中乳酸杆菌、双歧杆菌、拟杆菌的含量显著高于B组,粪便组织大肠杆菌、肠球菌、变形杆菌的含量显著低于B组。差异均具有统计学意义(P<0.05)。结论:乳果糖联合生长抑素治疗急性胰腺炎能够改善肠黏膜屏障功能、纠正肠道菌群紊乱并减轻炎症反应、抑制Fas/FasL所介导的免疫抑制。
Objective: To study the effects of lactulose combined with somatostatin on the expression of inflammatory mediators, intestinal microflora and Fas / FasL in patients with acute pancreatitis. Methods: Fifty-six patients with acute pancreatitis admitted to our hospital from May 2013 to October 2015 were randomly divided into group A and group B. Patients in group A received lactulose and somatostatin combined with conventional treatment and group B received Somatostatin combined with conventional treatment. Serum levels of inflammatory mediators, sFas, sFasL, Fas and FasL in peripheral blood and the number of copies of intestinal microflora in stool tissue were determined after 3 days of treatment. Results: Serum levels of IL-1β, IL-6, IL-8, IL-10, IL-18, sFas and sFasL in group A were significantly lower than those in group B The contents of Lactobacillus, Bifidobacterium and Bacteroides in the stool tissue were significantly higher than those in the B group. The contents of Escherichia coli, Enterococcus and Proteus in the stool tissue were significantly lower than those in the B group. The differences were statistically significant (P <0.05). Conclusion: The treatment of acute pancreatitis with lactulose combined with somatostatin can improve the barrier function of intestinal mucosa, correct the disturbance of intestinal flora, alleviate the inflammatory reaction and inhibit the immunosuppression mediated by Fas / FasL.