Effects of enteral nutrition on the gut barrier function in patients with severe acute pancreatitis / 中国医师进修杂志

ABSTRACT

Objective To investigate the effects of enteral nutrition (EN) on the gut barrier function in patients with severe acute pancreatitis (SAP) and explore its clinical significance.Methods A total of 40 SAP patients from December 2009 to December 2011 was collected in this study.The 40 cases were divided into total parenteral nutrition (TPN) group (20 cases) and EN group (20 cases).The APACHE Ⅱ score and serum expression of endotoxin and intestinal fatty acid binding protein (IFABP) were compared between two groups.The serum expression of endotoxin and IFABP was determined by enzyme-linked immunosorbent assay method.Results The APACHE Ⅱ score and serum expression of endotoxin and IFABP were significantly decreased in EN group and TPN group after treatment of 1,7,14,21 d (P ＜0.05).The APACHE Ⅱ score was lower in EN group than that in TPN group after treatment of 7,14,21 d [(7.03 ±1.86) scores vs.(8.12 ±2.11) scores,(5.32 ± 1.14) scores vs.(6.87 ± 1.35) scores,(3.49 ±0.83) scores vs.(5.15 ± 1.02) scores,P ＜ 0.05].The serum expression of endotoxin was lower in EN group than that in TPN group after treatment of 7,14,21 d [(48.18 ± 15.48) EU/L vs.(60.12 ± 18.16) EU/L,(33.46 ± 12.04) EU/L vs.(51.32 ± 14.66) EU/L,(22.15 ± 7.81) EU/L vs.(35.62 ± 12.53) EU/L,P ＜ 0.05].The serum expression of IFABP was lower in EN group than that in TPN group after treatment of 7,14,21 d [(18.47 ± 3.55) ng/L vs.(22.57 ± 4.14) ng/L,(10.32 ± 2.68) ng/L vs.(18.11 ± 3.62) ng/L,(6.39 ± 2.26)ng/L vs.(12.16 ±3.06) ng/L,P ＜0.05].The APACHE Ⅱ score was positively correlated with serum expression of endotoxin (r =0.612,P ＜ 0.05) and IFABP (r =0.634,P ＜ 0.05).The serum expression of endotoxin was positively correlated with IFABP (r =0.627,P ＜ 0.05).Conclusions EN treatment shows more effective effect on improving the gut barrier function in SAP patients than TPN treatment.And it is worthy to be popularized in the clinical application.