双歧杆菌四联活菌片对急性胰腺炎患者血清内毒素和降钙素原水平的影响及疗效观察

目的探讨双歧杆菌四联活菌片对急性胰腺炎患者血清内毒素和降钙素原（PCT）水平的影响及疗效观察。方法将66例急性胰腺炎患者随机分为观察组和对照组。两组患者均予以禁食禁饮、持续胃肠减压、预防感染、抑酸、解痉镇痛、抑制胰酶分泌和纠正水电解质酸碱紊乱等常规治疗。观察组患者加用双歧杆菌四联活菌片1.5 g进行水化后自胃管灌注,夹管2 h,3次/d,对照组除不使用双歧杆菌四联活菌片外余治疗同观察组。观察两组患者治疗前后血清内毒素和PCT水平的变化,并比较其临床疗效。结果治疗7 d后,两组患者血清内毒素和PCT水平均有不同程度的下降（P〈0.05或P〈0.01）,且观察组下降值比对照组更明显（P〈0.05）;同时观察组临床总有效率为93.94%,明显高于对照组的75.76%（χ2=4.24,P〈0.05）。结论双歧杆菌四联活菌片辅助治疗急性胰腺炎具有较好疗效,能明显降低血清内毒素和PCT水平,减轻肠源性内毒素血症,对肠黏膜屏障功能具有良好的保护作用。

Influence and curative effect of Bifidobacterium Tetravaccine Tablets on serum endotoxin and procalcitonin levels of patients with acute pancreatitis

Objective To discuss the influence and curative effect of Bifidobacterium Tetravaccine Tablets on serum endotoxin and procalcitonin （PCT） levels of patients with acute pancreatitis （AP）. Methods 166 cases of patients with AP were selected and divided into observation group and control group at random. Both groups were given conventional treatment including fasting and water-deprivation, continuous gastrointestinal decompression, infection prevention, acid suppression, antispasmodic and analgesic, inhibition of pancreatic secretion, correcting water electrolyte and acid-base disorders etc. The patients in observation group were additionally given 1.5 g Bifidobacterium Tetravaccine Tablets, perfused through stomach tube after hydration, pinched for 2 hours, three times a day. The changes of serum endotoxin and PCT levels of patients in both groups were observed, and the clinical curative effect was compared. Results After 7 days＇ medical treatment, the serum endotoxin and PCT levels of patients in both groups declined to some extents （ P 〈 0.05 or P 〈 0.01 ）, and the declining rate in observation group was much higher than that in control group （ P 〈 0.05 ）. Meanwhile, the total clinical efficiency in observation group was 93.94%, much higher than that in control group （75.76 % ） （X2 = 4.24, P 〈 0.05 ）. Conclusion Bifidobacterium Tetravaccine Tablets has favorable curative effect on AP as adjunctive therapy, which can obviously reduce serum endotoxin and PCT levels, reduce intestinal endotoxemia （IETM） and protect intestinal mucosal barrier function.