Effect of early enteral nutrition on serum endotoxin and intestinal permeability in patients with severe acute pancreatitis

Abstract

Objective To study the effect of early enteral nutrition (EN) on the serum endotoxin and intestinal permeability in patients with severe acute pancreatitis (SAP). Methods Seventy patients with SAP were selected as study objects, and they were divided into parenteral nutrition (PN) group and EN group according to the random number table method, with 35 cases in each group.The PN group was given PN intervention, while the EN group was given EN intervention.The levels of serum endotoxin and the ratio of the excretion rates of urinary lactulose and mannitol excretion before and after 1 week and 2 weeks of intervention, and the levels of inflammatory factors before and after treatment were measured. Results Before intervention, the levels of serum endotoxin and the ratio of the excretion rates of urinary lactulose and mannitol excretion had no statistically significant differences between the two groups (t=0.274, P=0.452; t=0.035, P=0.885). After 1 week and 2 weeks of intervention, the levels of serum endotoxin and the ratio of the excretion rates of urinary lactulose and mannitol excretion in the EN group were significantly lower than those in the PN group (t=9.024, 10.761, P=0.000, 0.000; t=6.935, 8.358, P=0.000, 0.000). After treatment, the levels of TNF-α, IL-1β, IL-6 and IL-8 in the EN group were significantly lower than those in the PN group (t=12.674, 10.318, 9.754, 8.307, P=0.000, 0.000, 0.000, 0.002). Conclusion EN has significant influence on the serum endotoxin and intestinal permeability in patients with SAP, and compared with PN, EN can promote the clearance of serum endotoxin, reduce the permeability of intestinal mucosa, and it is worth promoting. Key words: Parenteral nutrition; Pancreatitis, acute necrotizing; Toxoids