异甘草酸镁与谷氨酰胺联合肠内营养支持治疗重症急性胰腺炎的效果

夏秀梅　周伟

【摘要】 目的：探究异甘草酸镁与谷氨酰胺联合肠内营养支持治疗重症急性胰腺炎的效果。方法：选取笔者所在医院2018年5月-2019年8月SAP患者82例，根据治疗方案不同分为两组，各41例。对照组给予肠内营养支持，观察组于对照组基础上加用异甘草酸镁、谷氨酰胺。对比两组疗效、治疗7、14 d的APACHEⅡ评分及治疗前后肠黏膜屏障功能指标[二胺氧化酶（DAO）、D-乳酸]水平。结果：观察组总有效率高于对照组（P<0.05）;治疗7、14 d，观察组APACHEⅡ评分低于对照组（P<0.05）;治疗后观察组血清DAO、D-乳酸水平低于对照组（P<0.05）。结论：异甘草酸镁与谷氨酰胺联合肠内营养支持治疗SAP患者，可降低APACHEⅡ评分，改善肠黏膜屏障功能，疗效显著。

【关键词】 异甘草酸镁 谷氨酰胺 肠内营养支持 重症急性胰腺炎

doi：10.14033/j.cnki.cfmr.2020.16.018 文献标识码 B 文章编号 1674-6805（2020）16-00-03

Effect of Magnesium Isosglycyrrhizinate and Glutamine Combined with Enteral Nutrition Support in the Treatment of Severe Acute Pancreatitis/XIA Xiumei， ZHOU Wei. //Chinese and Foreign Medical Research， 2020， 18（16）： -48

[Abstract] Objective： To investigate the effect of Magnesium Isosglycyrrhizinate and Glutamine combined with enteral nutritional support in the treatment of severe acute pancreatitis. Method： A total of 82 cases of SAP patients in our hospital from May 2018 to August 2019 were selected， according to different treatment schemes， they were divided into two groups. 41 cases in each group. The control group was given enteral nutrition support， and the observation group was added with Magnesium Isosglycyrrhizinate and Glutamine on the basis of the control group. Compared the two groups of curative effect， APACHE Ⅱ score of treatment for 7， 14 days and intestinal mucosal barrier function indexes before and after the treatment [diamine oxidase （DAO）， D-lactate] levels. Result： The total effective rate of the observation group was higher than that of the control group （P<0.05）. Treatment for 7， 14 days， the APACHE Ⅱ score of study group were lower than those of the control group （P<0.05）. After treatment， serum DAO and D-lactic acid levels in the observation group were lower than those in the control group （P<0.05）. Conclusion： Magnesium Isosglycyrrhizinate， Glutamine combined with enteral nutrition support can reduce APACHE Ⅱ score and improve intestinal mucosal barrier function in SAP patients， with significant therapeutic effect.

[Key words] Magnesium Isosglycyrrhizinate Glutamine Enteral nutrition support Severe acute pancreatitis

First-authors address： Xiaogan Central Hospital， Xiaogan 432000， China

重症急性胰腺炎（severe acute pancreatits，SAP）为严重急腹症，可引发急性呼吸窘迫综合征、多器官衰竭、休克等并发症，病死率可达20%～30%[1-2]。肠内营养为SAP重要营养补给方式，可维护肠屏障，促进肠功能恢复及蛋白合成[3]。近年来，谷氨酰胺作为肠黏膜细胞危重应激状态下的唯一能量来源，在SAP治疗中的应用备受临床关注[4]。异甘草酸镁具有较好的抗炎及免疫调节作用[5]。本研究选取笔者所在医院SAP患者82例，探究异甘草酸镁与谷氨酰胺聯合肠内营养支持对其急性生理功能和慢性健康状况评分系统Ⅱ（APACHEⅡ）评分及肠黏膜屏障功能的影响，现报道如下。