摘要目的: 研究肠内营养(EN)对早期急性胰腺炎(AP)患者预后及血清中脂肪因子(脂联素、瘦素、网膜素、内脂素)的影响。方法: 将我院2015年1月至2017年12月收治的急性胰腺炎患者随机分为肠内营养组(治疗组,n=45)和禁食组(对照组,n=45);分别于患者入院时及治疗后3d内采外周血并通过ELISA法检测血清中脂肪因子的水平,再通过线性混合模型分析方法比较两组患者脂肪因子水平的差异。结果: 治疗组患者感染率明显低于对照组;治疗组患者前4d血清中网膜素的平均浓度明显高于对照组(63.5ng/mL vs 42.7ng/mL,P<0.05),前者血清中瘦素也明显高于后者(6.3ng/mL vs 3.7ng/mL,P<0.05);而两组患者血清中脂联素及内脂素则无明显差异(P>0.05)。结论: EN可明显降低AP患者感染发生率,亦可升高AP患者血清中网膜素及内脂素的水平,但EN是否通过调节脂肪因子水平来改善AP患者预后有待进一步研究。
Abstract：Objective: To study the effect of enteral nutrition for adipokines (adiponectin, leptin, omentin, visfatin) in patient with early acute pancreatitis. Methods: A total of 90 patients with AP from Jan. 2015 to Dec. 2017 were randomised to EN (n=45) and nil-by-mouth (NBM, n=45). Blood samples were taken on the first 4d of admission and adipokine concentrations was determined by ELISA assays. A linear mixed model analysis was used to determine differences in adipokine concentrations between the two study groups. Results: The infectious rate in patients with AP was lower than those with NBM. Omentin and leptin concentrations were significantly higher in patients with EN compared with NBM across the first 4 d of admission(63.5ng/ml vs 42.7ng/ml,6.3ng/ml vs 3.7ng/ml,P<0.05, respectively).No significant difference in adiponectin and visfatin concentrations were observed between the two groups. Conclusions: EN decreases the infectious rate in AP patients and it also increases omentin and leptin levels in AP. Further study is needed to understand whether these adipokines are responsible for the therapeutic benefits of EN.
李光辉, 吕飞飞. 肠内营养对早期急性胰腺炎患者血清脂肪因子的影响[J]. 河北医学, 2019, 25(6): 1030-1033.
LI Guanghui, LV Feifei. Influence on Enteral Nutrition for Adipokines in Patient with Early Acute Pancreatitis. HeBei Med, 2019, 25(6): 1030-1033.
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2019, Vol. 25 
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