Effects of early enteral nutrition + alanyl-glutamine on intestinal flora, inflammation and oxidative response in patients with SAP

摘要

Objective: To investigate the effects of early enteral nutrition + alanyl-glutamine on intestinal flora, inflammation and oxidative response in patients with severe acute pancreatitis (SAP). Methods: A total of 90 patients with SAP who were treated in the hospital between February 2013 and July 2017 were divided into normal EEN group and enhanced EEN group according to different nutritional modes. Normal EEN group received early EEN intervention, and enhanced EEN group received alanyl-glutamine intervention based on early EEN. The differences in the flora distribution in intestinal excreta as well as the contents of inflammatory factors and oxidative stress indexes in serum were compared between the two groups. Results:Before intervention, the differences in the flora distribution in intestinal excreta as well as the contents of inflammatory factors and oxidative stress indexes in serum were not statistically significant between the two groups of patients. After intervention, the bifidobacterium and lactobacillus count in intestinal excreta of enhanced EEN group were higher than those of normal EEN group whereas the enterococcus and escherichia coli count were lower than those of normal EEN group; serum inflammatory cytokines IL-1β, IL-17 and IL-23 contents were lower than those of normal EEN group; serum oxidative stress indexes MPO and XO contents were lower than those of normal EEN group while SOD and CAT contents were higher than those of normal EEN group. Conclusion: EEN combined with alanyl-glutamine therapy can effectively balance the intestinal flora and inhibit the systemic inflammatory response and oxidative stress response in patients with SAP.