Analysis of gut microbiota characteristics in severe acute pancreatitis and evaluation of clinical value of early enteral nutrition combined with probiotics treatment

doi:10.3877/cma.j.issn.2095-2015.2024.05.012

Abstract

Abstract:

Objective

To analyze the characteristics of gut microbiota in severe acute pancreatitis (SAP) and explore the clinical value of early enteral nutrition combined with probiotics treatment.

Methods

A prospective cohort study was used to select 80 patients with SAP who were treated in Cangzhou People's Hospital from January 2021 to December 2022 as the observation group. They were randomly divided into observation group A (40 cases) and observation group B (40 cases) using a random number table method. Twenty healthy individuals who underwent physical examination at the same time were selected as the control group. 16S rDNA V3-V4 segments were selected for PCR amplification, and the Illumina Miseq high-throughput sequencing platform was applied to analyze the characteristics of gut microbiota. Observation group A received early enteral nutrition, and observation group B received early enteral nutrition combined with probiotics for treatment. The clinical efficacy after treatment was evaluated, and the abdominal pressure, gastrointestinal function, serum inflammatory factors, serum lipase, amylase, and other indicators before and after treatment were compared.

Results

The α-diversity analysis results indicated that the Shannon index of the observation group was significantly lower than that of the control group (P<0.05). There was no statistically significant difference in the Chao index (P>0.05). At the level of gut microbiota, the observation group showed higher relative abundance in Proteobacteria and significantly lower relative abundance in Firmicutes. At the genus level, the observation group had a higher relative abundance of Escherichia coli and Bacteroids. The relative abundance of Brucella, Bifidobacterium, and Streptococcus was relatively low. The clinical efficacy of observation group B was better than that of observation group A (P<0.05). The amylase, lipase, lactate dehydrogenase, interleukin-6, tumor necrosis factor-α, procalcitonin, abdominal pressure, gastrointestinal function score in observation group B was significantly lower than those in observation group A after 7 days and 14 days of treatment (P<0.05).

Conclusion

The diversity and abundance of pathogenic bacteria in the gut microbiota of patients with SAP increase, while the diversity and abundance of beneficial bacteria decrease. Early enteral nutrition combined with probiotics improves the treatment effect of SAP and promotes the recovery of serum indicators.

Key words: Severe acute pancreatitis, Intestinal microbiota, Early enteral nutrition, Microecological preparations

Yanqiu Song, Guiyan Qi, Shuangshuang Yang, Ping Zhou. Analysis of gut microbiota characteristics in severe acute pancreatitis and evaluation of clinical value of early enteral nutrition combined with probiotics treatment[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2024, 14(05): 442-447.

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References 24

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组别	例数	性别[例(%)]		年龄(岁,±s)	民族[例(%)]
组别	例数	男	女	年龄(岁,±s)	汉族	其他
对照组	20	12(60.00)	8(40.00)	44.38±11.27	14(70.00)	6(30.00)
观察组	80	51(63.75)	29(36.25)	42.16±10.68	44(55.00)	36(45.00)
χ²/t值		0.097		0.822	1.478
P值		0.756		0.413	0.224
观察A组	40	27(67.50)	13(32.50)	41.77±10.81	24(60.00)	16(40.00)
观察B组	40	24(60.00)	16(40.00)	42.55±10.55	20(50.00)	20(50.00)
χ²/t值		0.487		0.327	0.808
P值		0.485		0.745	0.369

组别	例数	性别[例(%)]		年龄(岁,±s)	民族[例(%)]
组别	例数	男	女	年龄(岁,±s)	汉族	其他
对照组	20	12(60.00)	8(40.00)	44.38±11.27	14(70.00)	6(30.00)
观察组	80	51(63.75)	29(36.25)	42.16±10.68	44(55.00)	36(45.00)
χ²/t值		0.097		0.822	1.478
P值		0.756		0.413	0.224
观察A组	40	27(67.50)	13(32.50)	41.77±10.81	24(60.00)	16(40.00)
观察B组	40	24(60.00)	16(40.00)	42.55±10.55	20(50.00)	20(50.00)
χ²/t值		0.487		0.327	0.808
P值		0.485		0.745	0.369

组别	例数	痊愈	有效	无效	治疗有效率(%)
观察A组	40	28(70.00)	10(25.00)	2(5.00)	95.00
观察B组	40	19(47.50)	12(30.00)	9(22.50)	77.50

组别	例数	痊愈	有效	无效	治疗有效率(%)
观察A组	40	28(70.00)	10(25.00)	2(5.00)	95.00
观察B组	40	19(47.50)	12(30.00)	9(22.50)	77.50

组别	例数	腹内压			F值	P值
组别	例数	治疗前	治疗7 d	治疗14 d	F值	P值
观察A组	40	18.74±4.47	16.21±3.48	13.56±3.01	21.131	<0.001
观察B组	40	19.11±4.92	14.48±3.08	12.05±3.38	34.222	<0.001
t值		0.352	2.354	2.110
P值		0.726	0.021	0.038

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