Effects of Enteral Nutrition Supplemented Probiotics and Glutamine on the Intestinal Mucosal Barrier Recovery in Patients with Severe Acute Pancreatitis

Objective To evaluate the effect of enteral nutrition supplemented probiotics and glutamine on the intestinal mucosal barrier recovery in patients with severe acute pancreatitis. Methods 74 patients with severe acute pancreatitis were randomly divided into 3 groups: enteral nutrition( EN group),enteral nutrition + glutamine( G1 n group), enteral nutrition + glutamine + probiotics( probiotics group). APACHEⅡ score was used to evaluate the patients. Blood samples were collected on day 1,7,14,21 after treatment for the concentration of glutamine, plasma endotoxi, plasma diamine oxidase( DAO),C- reactive protein( CRP). Results 7 day after treatment,the CRP level of Gln group and probiotics group wers decreasd,there were significance statistical difference when compared with the EN group. There was significant difference among the three groups in APACHEⅡ score. the concentration of glutamine were decreased in the three group on the 7th day after treatment. There was no significant difference among the three groups. The levels of Gln in three groups were rise on the 14 th day after treatment. There was significant difference between EN group and probiotics group. The level of plasma endotoxi and D- lactic acid of probiotics group were lower than EN group on 7th day after treatment,The difference was statistically significant. The level of plasma endotoxi and D- lactic acid of probiotics group and Gln group were lower than EN group on 14 th day after treatment, the difference was statistically significant. Conclusion Application of probiotics and Gln enteral nutrition can better maintain the intestinal barrier integrity and have broad application prospects. But the synergistic effect between probiotics and Glnimmune need for further study.