Effects Of Probiotics On Intestinal Barrier,Nutrition And Inflammatory Status In Enteral Nutrition Support Critically Ill Patients

Objectives With the renewal of the critical care concept,the application of probiotics in the clinical nutrition treatment of critically ill patients has been gradually paid attention to.Based on the patient's condition and gastrointestinal function,Peifei Kang was used combinaed with nutritional support.On the first and seventh days of enrollment,the nutritional status,gastrointestinal function and inflammatory index of the patients were evaluated,and the clinical outcomes of critically ill patients were recorded to explore the effects of probiotics on the nutritional status,gastrointestinal function and clinical outcomes of critically ill patients.Measures According to the ratio of 2:1,total 98 critically ill patients admitted to the intensive care unit(ICU)from July 2016 to October 2018 were randomly divided into the enteral nutrition group(Enteral nutrition,EN group)and Probiotics combined with enteral nutrition group(Enteral nutrition+Probiotics,EN+P group),all patients were treated with the required clinical treatment.The EN+P group was supplemented with Peficon on the basis of enteral nutrition support.On the first and seventh days after enrollment,the patients' Subjective Global Assessment(SGA)and Acute Gastrointestinal Injury(AGI)were scored,height and weight were measured,body mass index(BMI)was calculated,and Trieeps Skin-Fold(TSF)were measured.;peripheral venous blood was collected,and Hemoglobin(HGB)?Albumin(ALB)?Prealbumin(PA)?White Blood Cell(WBC)?Total Lymphocytc Count(TLC)?C-Reactive Protein(CRP)?Triglycerides(TG)?Total Cholesterol(TCH)?High Density Lipoprotein Cholesterol(HDL-C)?Serum creatinine(Scr)?Blood Ureanitrogen(BUN)were measured by automatic biochemical analyzer,and Intestinal Fatty Acid Binding Protein(IFABP)?TNF-??IL-6?IL-12 were determined by Elisa method.The clinical outcome of the patient was also recorded.T test or Z test were used for analysing the changes in nutritional indexs,gut barrier function,inflammatory indexs.Results In this study,60 male patients and 30 female patients,with an average age of(53.46±15.62)years old.12.2% of patients died within 28 days of the end of the study.There were no significant differences in gender,age,APACHE II score,mortality,body mass index,and SGA scores between the two groups(P>0.05).After treatment,the risk of malnutrition increased in the EN group,and there was no significant change in the EN+P group.There was no significant difference in the thickness of the triceps skin fold between the two groups(P>0.05).After treatment in the EN+P group The nutritional status indicators serum albumin,prealbumin,serum creatinine levels have an upward trend,the difference was statistically significant(P <0.05),hemoglobin and urea nitrogen levels did not change significantly(P> 0.05);EN group hemoglobin There was a downward trend in serum creatinine.The urea nitrogen in the EN group had an upward trend,and the difference was statistically significant(P<0.05).Triglycerides showed an upward trend in both groups,and high-density lipoprotein cholesterol decreased,and the difference was statistically significant(P<0.05).The results of gastrointestinal function and intestinal barrier showed that the AGI scores in the EN+P group showed a significant decrease,and the difference was statistically significant(P<0.05).The intestinal fatty acids of the two groups were decreased,but the decrease of intestinal fatty acid binding protein in EN+P group was more significant(P<0.05).The effect of Peifeikang combined with enteral nutrition support on the inflammatory condition of critically ill patients showed that there was no significant difference in white blood cell count and lymphocyte count between EN+P group after treatment(P>0.05),C-reactive protein There was a trend of decrease,and the difference was statistically significant(P<0.05).There was no significant difference in white blood cell count,lymphocyte count and C-reactive protein level between the EN group(P>0.05).The two groups of patients had TNF-?.IL-6 and IL-12 showed a decreasing trend,but the decrease of TNF-? in EN+P group was more obvious,and the difference was statistically significant(P<0.05).Conclusions Probiotics can improve the intestinal barrier and inflammatory status of critically ill patients with enteral nutrition support.In the short term,the improvement of nutritional status of critically ill patients is not significant,but the risk of preventing malnutrition is aggravated.And the reduction of hemoglobin levels has a certain significance.