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目的:探讨早期肠道应用微生态制剂双歧杆菌三联活菌胶囊(培菲康)对急性重症胰腺炎患者血清炎性介质白细胞介素-8(IL-8)和肿瘤坏死因子α(TNF-α)水平的影响及可能的临床意义。方法:45例患者随机分为两组,试验组(培菲康+肠内营养,n=20)和对照组(肠内营养,n=25),两组患者入院确诊后对症支持、肠内营养、抗感染、抑酸及抑制胰腺分泌等处理均相同,试验组加用培菲康,每隔12 h 1次,每次4粒,每粒210 mg,疗程14 d。治疗前1 d、治疗后7 d和14 d抽血,ELISA法检测血清IL-8和TNF-α水平,同时观察血淀粉酶、血白细胞及预后变化。结果:两组患者治疗后7 d及14 d血清IL-8和TNF-α水平均显著降低,试验组的炎症介质水平在14d时低于对照组(P<0.05)。另外,血淀粉酶及白细胞总数14 d时试验组较对照组为低(P<0.05),胃肠功能评分有所降低,多器官衰竭、感染、上消化道出血试验组稍低,死亡率两组间无统计学差异。结论:肠道微生态制剂培菲康可明显降低血中炎性介质的量,并由此调整肠内菌群平衡,改善肠道黏膜屏障和胃肠功能,减少感染等并发症的发生,值得进一步研究。
OBJECTIVE: To investigate the effect of early intestinal application of probiotics Bifidobacterium triple viable capsule (Peifukang) on serum inflammatory mediators of interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α) in patients with severe acute pancreatitis α) levels and the possible clinical significance. Methods: Forty-five patients were randomly divided into two groups. The experimental group (Pefikan + enteral nutrition, n = 20) and the control group (enteral nutrition, n = 25) Nutrition, anti-infection, acid suppression and inhibition of pancreatic secretion and other treatments are the same test group plus Peifen Kang, once every 12 h, each 4, 210 mg each, treatment 14 d. Blood samples were collected on the first day before treatment and on the 7th day and the 14th day after the treatment. Serum levels of IL-8 and TNF-α were measured by ELISA. Blood amylase, leukocyte count and prognosis were also observed. Results: Serum levels of IL-8 and TNF-α decreased significantly on the 7th day and the 14th day after treatment in both groups. The levels of inflammatory mediators in the experimental group were lower than those in the control group on the 14th day (P <0.05). In addition, blood amylase and leukocyte count at 14 d were lower in the test group than in the control group (P <0.05), gastrointestinal function scores decreased, multiple organ failure, infection, upper gastrointestinal bleeding test group slightly lower mortality rate of two No significant difference between groups. Conclusions: Pefikang, an intestinal probiotics, can significantly reduce the amount of inflammatory mediators in the blood, and thus adjust the intestinal flora balance, improve the intestinal mucosal barrier and gastrointestinal function, reduce the incidence of complications such as infection, it is worth further research.