Relationship between intestinal flora and acute respiratory distress syndrome in patients with severe acute pancreatitis
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目的 探讨重症急性胰腺炎患者肠道菌落情况与其并发急性呼吸窘迫综合征的关系。 方法 采用前瞻性研究的方法，选取2019年3月至2021年2月浙江省医疗健康集团杭州医院收治的106例重症急性胰腺炎患者为观察组，根据是否并发急性呼吸窘迫综合征将其分为并发组52例和无并发组54例。另选取同期健康体检者100例为对照组，分析重症急性胰腺炎患者肠道菌落情况与其并发急性呼吸窘迫综合征的关系。 结果 观察组和对照组的肠道菌群数目（乳酸杆菌、双歧杆菌、大肠埃希菌）比较差异有统计学意义（t = 49.69、73.28、46.32，P<0.05）。并发组与非并发组菌群的肠道菌群数目（乳酸杆菌、双歧杆菌、大肠埃希菌）比较差异有统计学意义（t = 34.85、39.71、23.47，P<0.05）。并发组血清内毒素、二胺氧化酶以及D-乳酸水平均显著高于非并发组[（0.63 ± 0.16）EU/ml比（0.45 ± 0.08）EU/ml、（6.29 ± 1.18）U/ml比（4.89 ± 0.91）U/ml、（11.63 ± 2.84）mmol/L比（9.33 ± 2.61）mmol/L]，差异有统计学意义（t = 7.37、6.85、4.34，P<0.05）。Spearman分析结果显示重症急性胰腺炎并发急性呼吸窘迫综合征与其肠道乳酸杆菌、双歧杆菌菌群数目呈负相关（r = - 0.342和- 0.291，P = 0.011和0.021），与其肠道大肠埃希菌菌群数目呈正相关（r = 0.263，P = 0.033）。 结论 重症急性胰腺炎患者普遍存在肠道菌落失衡，且并发急性呼吸窘迫综合征患者肠道菌落失衡和肠道黏膜屏障功能受损情况更严重，重症急性胰腺炎并发急性呼吸窘迫综合征与其肠道菌落情况存在明显相关性。 Objective To investigate the relationship between intestinal flora and acute respiratory distress syndrome in patients with severe acute pancreatitis. Methods One hundred and six patients with severe acute pancreatitis admitted to a hospital from March 2019 to February 2021 were selected as the observation group for prospective analysis. They were divided into concurrent group (52 cases) and non-concurrent group (54 cases) according to whether they were complicated with acute respiratory distress syndrome. In addition, 100 healthy people in the same period were selected as the control group to analyze the relationship between intestinal flora and acute respiratory distress syndrome in patients with severe acute pancreatitis. Results There were significant differences in the number of intestinal flora (Lactobacillus, Bifidobacterium, Escherichia coli) between the observation group and the control group (t = 49.69, 73.28 and 46.32 P<0.05). There were significant differences in the number of intestinal flora (Lactobacillus, Bifidobacterium, Escherichia coli) between the concurrent group and the non-concurrent group (t = 34.85, 39.71 and 23.47 P<0.05). The levels of serum endotoxin, diamine oxidase and D-lactic acid in the concurrent group were significantly higher than those in the non-concurrent group: (0.63 ± 0.16) EU/ml vs. (0.45 ± 0.08) EU/ml, (6.29 ± 1.18) U/ml vs. (4.89 ± 0.91) U/ml, (11.63 ± 2.84) mmol/L vs. (9.33 ± 2.61) mmol/L (t = 7.37, 6.85 and 4.34, P<0.05). Spearman analysis showed that severe acute pancreatitis complicated with acute respiratory distress syndrome was negatively correlated with the number of intestinalLactobacillus and Bifidobacterium (r = - 0.342 and - 0.291, P = 0.011 and 0.021), which was positively correlated with the number of intestinal Escherichia coli flora (r = 0.263, P = 0.033). Conclusions Intestinal colony imbalance is common in patients with severe acute pancreatitis, and the imbalance of intestinal colony and the impairment of intestinal mucosal barrier function are more serious in patients with acute respiratory distress syndrome. There is a significant correlation between severe acute pancreatitis complicated with acute respiratory distress syndrome and its intestinal colony.
Objective To investigate the relationship between intestinal flora and acute respiratory distress syndrome in patients with severe acute pancreatitis. Methods One hundred and six patients with severe acute pancreatitis admitted to a hospital from March 2019 to February 2021 were selected as the observation group for prospective analysis. They were divided into concurrent group (52 cases) and non-concurrent group (54 cases) according to whether they were complicated with acute respiratory distress syndrome. In addition, 100 healthy people in the same period were selected as the control group to analyze the relationship between intestinal flora and acute respiratory distress syndrome in patients with severe acute pancreatitis. Results There were significant differences in the number of intestinal flora (Lactobacillus, Bifidobacterium, Escherichia coli) between the observation group and the control group (t = 49.69, 73.28 and 46.32 P<0.05). There were significant differences in the number of intestinal flora (Lactobacillus, Bifidobacterium, Escherichia coli) between the concurrent group and the non-concurrent group (t = 34.85, 39.71 and 23.47 P<0.05). The levels of serum endotoxin, diamine oxidase and D-lactic acid in the concurrent group were significantly higher than those in the non-concurrent group: (0.63 ± 0.16) EU/ml vs. (0.45 ± 0.08) EU/ml, (6.29 ± 1.18) U/ml vs. (4.89 ± 0.91) U/ml, (11.63 ± 2.84) mmol/L vs. (9.33 ± 2.61) mmol/L (t = 7.37, 6.85 and 4.34, P<0.05). Spearman analysis showed that severe acute pancreatitis complicated with acute respiratory distress syndrome was negatively correlated with the number of intestinalLactobacillus and Bifidobacterium (r = - 0.342 and - 0.291, P = 0.011 and 0.021), which was positively correlated with the number of intestinal Escherichia coli flora (r = 0.263, P = 0.033). Conclusions Intestinal colony imbalance is common in patients with severe acute pancreatitis, and the imbalance of intestinal colony and the impairment of intestinal mucosal barrier function are more serious in patients with acute respiratory distress syndrome. There is a significant correlation between severe acute pancreatitis complicated with acute respiratory distress syndrome and its intestinal colony.
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