摘要
目的:探究丙氨酰-谷氨酰胺联合微生态制剂对食管早癌内镜粘膜下剥离术(ESD)术后肠黏膜屏障功能的影响。方法:选取2020年3月至2022年12月入新乡医学院第一附属医院行ESD术的食管早癌病人96例,随机分为对照组(n=48)和干预组(n=48)。对照组病人予以常规术前禁食、术后基础治疗及营养支持,干预组术前第3天予开始注射丙氨酰-谷氨酰胺和口服微生态制剂(双歧杆菌四联活菌片),术后第1~7天同时予以丙氨酰-谷氨酰胺和微生态制剂。比较两组病人早期肠内营养耐受性、肠道菌群分布、肠黏膜屏障功能、营养指标、炎症因子、免疫功能及术后康复情况。结果:术后7 d,干预组病人肠道不耐受症状的发生率显著低于对照组的(14.58%vs 37.50%,P<0.05)。术后,干预组双歧杆菌、乳酸杆菌较对照组增多,大肠杆菌较对照组少,二胺氧化酶、内毒素和D-乳酸水平较对照组低,总蛋白(TP)、白蛋白(Alb)和前白蛋白(PA)水平较对照组高,白细胞介素(IL-1β、-6、-8)水平较对照组低,CD3^(+)和CD4^(+)/CD8^(+)水平较对照组高(P<0.05);干预组术后首次排气时间、排便时间及住院时间短于对照组(P<0.05)。结论:给予丙氨酰-谷氨酰胺联合微生态制剂可有效提高食管早癌病人术后早期肠内营养耐受性,减轻肠黏膜屏障功能损伤,改善营养状况,提升免疫力。
Objective:To explore the effects of alanyl-glutamine combined with probiotics on intestinal mucosal barrier function in patients with early-stage esophageal cancer receiving endoscopic submucosal dissection(ESD).Methods:A total of 96 patients with early-stage esophageal cancer undergoing ESD were enrolled and randomly divided into control group(n=48)and intervention group(n=48)from March 2020 to December 2022 in the first affiliated hospital of Xinxiang medical college.The control group was given routine preoperative fasting,postoperative standard treatment and nutritional support,while intervention group was given alanyl-glutamine injection+oral probiotics(tetralogy of viable bifidobacterium tablets)on 3d before surgery and 1d-7d after surgery.The enteral nutrition feeding tolerance,distribution of intestinal floras,intestinal mucosal barrier function,nutritional indexes,inflammatory factors,immune function and postoperative rehabilitation were compared between the two groups.Results:At 7d after surgery,the incidence of feeding intolerance in intervention group was significantly lower than that in control group(14.58%vs 37.50%,P<0.05).Compared with control group,counts of Bifidobacteria and Lactobacillus were increased,count of Escherichia coli was decreased,levels of diamine oxidase,endotoxin and D-lactic acid were decreased,levels of total protein(TP),albumin(Alb)and prealbumin(PA)were increased,levels of interleukin(IL)-1β,IL-6 and IL-8 were decreased,and levels of^(+)CD3 and^(+)CD4^(+)/CD8 were increased in intervention group(P<0.05)in the postoperative stage.The postoperative first exhaust time,defecation time and hospitalization time in intervention group were remarkably shorter than those in control group(P<0.05).Conclusion:Alanyl-glutamine combined with probiotics can effectively improve enteral nutrition feeding tolerance,relieve intestinal mucosal barrier injury,improve nutritional status and enhance immune function in patients with early-stage esophageal cancer undergoing ESD.
作者
张彩凤
姜旭
姬娟娟
张超群
张龙
杜学芳
韩宇
ZHANG Cai-feng;JIANG Xu;JI Juan-juan;ZHANG Chao-qun;ZHANG Long;DU Xue-fang;HAN Yu(Department of Gastroenterology,The First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,Henan,China)
出处
《肠外与肠内营养》
CAS
CSCD
北大核心
2024年第1期17-21,共5页
Parenteral & Enteral Nutrition
基金
河南省医学科技攻关计划(LHGJ20210531)。
关键词
食管早癌
内镜粘膜下剥离术
丙氨酰-谷氨酰胺
微生态制剂
肠黏膜屏障功能
免疫功能
Early-satge esophageal cancer
Endoscopic submucosal dissection
Alanyl-glutamine
Probiotics
Intestinal mucosal barrier function
Immune function
