摘要
目的探讨添加益生菌的早期肠内营养对脓毒血症休克患者血清炎症因子的影响。方法选取2015年2月15日至2017年3月15日来该院接受治疗的脓毒血症休克患者60例作为研究对象,将其分为A(早期肠道内营养+抗生素治疗)、B(益生菌+早期肠道内营养+抗生素治疗)两组。观察两组患者治疗前后营养状况指标、血清炎症因子指标,观察随访3个月内死亡和存活患者入院时炎症因子指标,并进行Logistic回归分析。结果两组患者治疗后各指标均显著降低,且B组显著低于A组,差异具有统计学意义(P<0.05);两组患者治疗后白细胞介素(IL)-1、IL-6、IL-8和肿瘤坏死因子(TNF)-α与治疗前相比,均显著降低,差异具有统计学意义(P<0.05)。B组各项指标显著低于A组,差异具有统计学意义(P<0.05);死亡组入院时各项炎症因子均显著高于存活组,差异具有统计学意义(P<0.05)。Logistic回归分析可知,IL-1(OR=1.591,95%CI1.005~1.863)、IL-6(OR=1.347,95%CI 1.121~1.684)、IL-8(OR=1.529,95%CI 1.225~1.645)、TNF-α(OR=2.545,95%CI 1.658~2.664)是脓毒血症休克患者死亡的危险因素,差异具有统计学意义(P<0.05)。结论添加益生菌的早期肠内营养对脓毒血症休克患者血清部分炎症因子具有下调作用,抗炎作用明显,减少患者病死率,值得推广。
Objective To investigate the effect of early enteral nutrition adding probiotics on serum inflammatory factors in septic shock patients.Methods Sixty patients with septic shock receiving the treatment in this hospital from February 15,2015 to March 15,2017 served as the study subjects and randomly divided into the group A(early enteral nutrition+ antibiotic therapy)and B(probiotics+ early enteral nutrition+antibiotic therapy).The nutritional status indexes and serum inflammatory factors before and after treatment were observed in the two groups.The inflammatory factor indicators at admission were observed in the dead patients within 3-month follow up period or survival patients and the Logistic regression analysis was performed..Results The various indexes after treatment in the two groups were significantly decreased,moreover the group B was significantly lower than the group A,the difference was statistically significant(P<0.05).The levels of IL-1,IL-6,IL-8 and TNF-αafter treatment in the two groups were significantly decreased compared with before treatment,the difference was statistically significant(P<0.05).The indexes in the group B were significantly lower than those in the group A the difference was statistically significant(P<0.05).The levels of inflammatory factors at admission in the death group were significantly higher than those in the survival group,the difference was statistically significant(P<0.05).The Logistic regression analysis showed that IL-1(OR=1.591,95%CI=1.005-1.863),IL-6(OR=1.347,95%CI=1.121-1.684),IL-8(OR=1.529,95%CI=1.225-1.645)and TNF-α(OR=2.545,95%CI=1.658-2.664)were the risk factors for death in the patients with septic shock,the difference was statistically significant(P<0.05).Conclusion The early enteral nutrition adding probiotics has a down-regulation effect on partial serum inflammatory cytokines in the patients with septic shock,has obvious anti-inflammatory effect and reduces mortality,and is worthy of popularization.
出处
《重庆医学》
CAS
2018年第21期2804-2806,2811,共4页
Chongqing medicine
关键词
肠道营养
休克
脓毒性
益生菌
血清炎症因子
enteral nutrition
shock
septic
probiotics
serum inflammatory cytokines
