肠内营养对活动期溃疡性结肠炎伴营养不良患者营养状况、肠黏膜屏障功能和肠道菌群的影响

摘要 目的：观察肠内营养对活动期溃疡性结肠炎（UC）伴营养不良患者营养状况、肠黏膜屏障功能和肠道菌群的影响。方法：选取2019年8月~2021年9月期间上海长征医院收治的120例活动期UC伴营养不良患者，根据随机数字表法分为对照组（60例，接受全肠外营养治疗）和研究组（60例，接受肠内营养治疗）。观察两组治疗3周后的临床总有效率，对比两组治疗前、治疗3周后的营养状况、肠黏膜屏障功能指标和肠道菌群数量，记录两组治疗期间不良反应发生率。结果：研究组（90.00%）临床总有效率高于对照组（68.33%）（P<0.05）。研究组治疗3周后D-乳酸（D-LA）、二胺氧化酶（DAO）、内毒素（ET）水平低于对照组同期（P<0.05）。研究组治疗3周后血清白蛋白、血红蛋白水平高于对照组同期（P<0.05）。研究组治疗3周后乳酸杆菌、双歧杆菌数量高于对照组同期，大肠杆菌数量则低于对照组同期（P<0.05）。两组不良反应发生率对比无差异（P>0.05）。结论：活动期UC伴营养不良患者选用肠内营养进行治疗，可促进营养状况和肠黏膜屏障功能改善，调节肠道菌群结构，安全有效。

Effects of Enteral Nutrition on Nutritional Status, Intestinal Mucosal Barrier Function and Intestinal Flora in Patients with Active Ulcerative Colitis with Malnutrition

ABSTRACT Objective: To observe the effects of enteral nutrition on nutritional status, intestinal mucosal barrier function and intestinal flora in patients with active ulcerative colitis (UC) with malnutrition. Methods: 120 patients with active UC with malnutrition who were treated in Shanghai Changzheng Hospital from August 2019 to September 2021 were selected, they were randomly divided into control group (60 cases, treated with total parenteral nutrition) and study group (60 cases, treated with enteral nutrition). The total clinical effective rate of the two groups 3 weeks after treatment were observed, the nutritional status, intestinal mucosal barrier function index and intestinal flora of the two groups before and 3 weeks after treatment were compared, and the incidence of adverse reactions during the treatment of the two groups were recorded. Results: The total clinical effective rate of the study group (90.00%) was higher than that of the control group (68.33%) (P<0.05). The levels of D-lactic acid (D-LA), diamine oxidase (DAO) and endotoxin (ET) in the study group were lower than those in the control group at 3 weeks after treatment (P<0.05). The levels of serum albumin and hemoglobin in the study group were higher than those in the control group at 3 weeks after treatment(P<0.05). The number of Lactobacillus and Bifidobacterium in the study group was higher than that in the control group, while the number of Escherichia coli was lower than that in the control group at 3 weeks after treatment (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: Enteral nutrition can promote the improvement of nutritional status and intestinal mucosal barrier function, regulate the structure of intestinal flora, which is safe and effective.