早期应用复合乳酸菌预防呼吸机相关肺炎的临床疗效及其对IL-6和IL-17水平的影响

摘要

Objective To investigate the clinical effect of compound lactobacillus for preventing ventilator as‐sociated pneumonia(VAP) and its influence on the levels of interleukin‐6(IL‐6) and interleukin‐17(IL‐17) .Methods 230 critical patients in ICU from January to December 2014 were consecutively enrolled in this study and randomly and equally divided into the probiotics group and the control group .The occurrence rate of VAP ,mortality rate ,clini‐cal curative effect and ICU duration were compared between the two groups .The levels of IL‐6 ,IL‐17 and PCT were analyzed and compared between these two groups .Results The occurrence rate of VAP in the probiotics group was 26 .1% ,which was significantly lower than 55 .7% in the control group ,the difference was statistically significant (P<0 .05) ,the time of VAP appearance in the probiotics group was significantly posterior to the control group (P<0 .05) ,and mean ICU duration in the probiotics group was significantly shorter than that in the control group (P<0 .05) .The levels of PCT ,IL‐6 and IL‐17 at the early stage in the probiotics group were significantly lower than those in the control group(P<0 .05) .Conclusion The early adiministration of compound lactobacillus in the patients with mechanical ventilation may effectively prevent the VAP ocurrence .%目的：探讨早期应用复合乳酸菌预防呼吸机相关肺炎（VAP）的临床疗效及其对白细胞介素（IL）‐6和IL‐17水平的影响。方法连续性纳入2014年1～12月ICU住院治疗的230例重症患者，随机平均分为益生菌组和对照组。比较两组患者VAP发生率、病死率、临床治疗效果及ICU住院时间等临床指标。同时分析比较降钙素原（PCT）、IL‐6及IL‐17水平。结果益生菌组患者VAP发生率（26．1％）明显低于对照组（55．7％），差异有统计学意义（P＜0．05），并且益生菌组患者出现VAP的时间明显晚于对照组（P＜0．05），平均ICU住院时间方面，益生菌组也明显优于对照组（P＜0．05）。在治疗早期（治疗后第4天）益生菌组PCT、IL‐6、IL‐17水平均明显低于对照组（P＜0．05）。结论机械通气患者早期使用复合乳酸杆菌制剂可以有效预防VAP的发生。