Efficacy of different enteral nutrition drugs for severe acute pancreatitis and their gastrointestinal tolerance

CHEN Xu; DENG Yi; LI Qiang; WU Di

doi:10.6039/j.issn.1001-0408.2023.24.16

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Efficacy of different enteral nutrition drugs for severe acute pancreatitis and their gastrointestinal tolerance

更新时间：2023-12-22

- Efficacy of different enteral nutrition drugs for severe acute pancreatitis and their gastrointestinal tolerance
- ZHONGGUO YAOFANG Vol. 34, Issue 24, Pages: 3046-3050(2023)
- 作者机构：
  
  1.电子科技大学医学院附属妇女儿童医院/成都市妇女儿童中心医院药学部，成都　611731
  2.江苏省人民医院胰腺中心，南京　210029
  3.江苏省人民医院药学部，南京　210029
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2023.24.16
  CLC： R969.3
- Published：30 December 2023，
  
  Received：10 August 2023，
  
  Revised：23 November 2023，
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陈旭,邓毅,李强等.不同肠内营养制剂用于重症急性胰腺炎的疗效及胃肠道耐受性研究 ^Δ[J].中国药房,2023,34(24):3046-3050.

CHEN Xu,DENG Yi,LI Qiang,et al.Efficacy of different enteral nutrition drugs for severe acute pancreatitis and their gastrointestinal tolerance[J].ZHONGGUO YAOFANG,2023,34(24):3046-3050.
陈旭,邓毅,李强等.不同肠内营养制剂用于重症急性胰腺炎的疗效及胃肠道耐受性研究 ^Δ[J].中国药房,2023,34(24):3046-3050. DOI： 10.6039/j.issn.1001-0408.2023.24.16.

CHEN Xu,DENG Yi,LI Qiang,et al.Efficacy of different enteral nutrition drugs for severe acute pancreatitis and their gastrointestinal tolerance[J].ZHONGGUO YAOFANG,2023,34(24):3046-3050. DOI： 10.6039/j.issn.1001-0408.2023.24.16.

摘要

目的

比较不同肠内营养（EN）制剂用于重症急性胰腺炎（SAP）患者的疗效和胃肠道耐受性。

方法

收集2022年1月1日－2023年6月30日于江苏省人民医院胰腺中心住院治疗的118例SAP患者的临床资料，按使用EN制剂的不同分为短肽类EN制剂（SP）组（41例）、不含膳食纤维的整蛋白EN制剂（TP-MCT）组（40例）和含膳食纤维的整蛋白EN制剂（TPF-DM）组（37例）。3组患者均鼻饲24 h连续泵注EN制剂，能量目标量均为25～30 kcal/kg。收集3组患者用药前和用药7 d后的血液营养指标[白蛋白（ALB）、总蛋白（TP）、血红蛋白（Hb）、球蛋白（GLB）]和炎症指标[白细胞（WBC）、中性粒细胞百分比（N%）、降钙素原（PCT）、C反应蛋白（CRP）、白细胞介素6（IL-6）]，并汇总其临床结局指标[入住重症监护室（ICU）时间、住院时长、恢复经口饮食时长、病情未好转率、死亡率]及胃肠道耐受情况。

结果

用药后，3组患者的ALB、TP均显著高于同组用药前（

＜0.05）；3组患者的CRP、N%，TP-MCT组患者的PCT和SP组患者的IL-6均显著低于同组用药前，且TP-MCT组的PCT和SP组的IL-6均显著低于同期的其他两组（

＜0.05）；3组间用药后ALB、TP、CRP、N%比较及3组用药前后的Hb、GLB、WBC比较，差异均无统计学意义（

＞0.05）。3组患者的临床结局指标比较，差异均无统计学意义（

＞0.05）。TP-MCT组患者的胃肠道总不良反应发生率最低（32.50%），且显著低于SP组（46.34%）和TPF-DM（48.65%）（

＜0.05）。

结论

不同EN制剂均能不同程度地改善SAP患者的营养状态并降低炎症反应，其中SP和TP-MCT的疗效较显著，且后者的胃肠道耐受性较好。

Abstract

OBJECTIVE

To compare the efficacy of different enteral nutrition （EN） drugs for severe acute pancreatitis （SAP） and their gastrointestinal tolerance.

METHODS

A total of 118 SAP patients admitted to the Pancreatic Center of Jiangsu Provincial People’s Hospital from January 1， 2022 to June 30， 2023 were collected and divided into short-peptide EN drugs （SP） group （41 cases）， dietary fiber-free intact protein EN drugs （TP-MCT） group （40 cases） and dietary fiber-containing intact protein EN drugs （TPF-DM） group （37 cases） according to the types of EN. All three groups of patients were given continuous pumps of EN drugs via nasal feeding for 24 hours， with a target energy dose of 25-30 kcal/kg. The blood nutritional indexes [albumin （ALB）， total protein （TP）， hemoglobin （Hb）， globulin （GLB）]， inflammation indexes [white blood cells （WBC）， percentage of neutrophils （N%）， procalcitonin （PCT）， C-reactive protein （CRP）， interleukin-6 （IL-6）]， clinical outcomes indexes [time of stay in the intensive care unit （ICU）， length of hospital stay， duration of resuming oral diet， the rate of cases without improvement， mortality rate] and the occurrence of gastrointestinal tolerance were collected from 3 groups before medication and 7 d after medication.

RESULTS

After treatment， ALB and TP in 3 groups were significantly higher than before treatment （

＜0.05）； CRP and N% of 3 groups， PCT of TP-MCT group and IL-6 of SP group were significantly lower than corresponding group before medication （

＜0.05）； PCT of TP-MCT group and IL-6 of SP group were significantly lower than those of other two groups at corresponding period （

＜0.05）. There were no statistical significances in ALB， TP， CRP or N% among the three groups after medication， and in Hb， GLB or WBC among the three groups before and after treatment （

＞0.05）. There was no significant difference in clinical outcome indexes among 3 groups （

＞0.05）. The incidence of gastrointestinal adverse reactions in the TP-MCT group was the lowest （32.50%）， and significantly lower than those in the SP group （46.34%） and TPF-DM group （48.65%）（

＜0.05）.

CONCLUSIONS

Different EN preparations can improve the nutritional status and reduce the inflammatory response in SAP patients to different extents， among which SP and TP-MCT are more effective， and TP-MCT shows the better gastrointestinal tolerance.

关键词

肠内营养重症急性胰腺炎疗效耐受性不良反应

Keywords

severe acute pancreatitistherapeutic efficacytoleranceadverse reaction

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