CAJ | 학술논문

目的：探讨早期应用复合乳酸菌预防呼吸机相关肺炎（VAP）的临床疗效及其对白细胞介素（IL）‐6和IL‐17水平的影响。方法连续性纳入2014年1～12月ICU住院治疗的230例重症患者，随机平均分为益生菌组和对照组。比较两组患者VAP发生率、病死率、临床治疗效果及ICU住院时间等临床指标。同时分析比较降钙素原（PCT）、IL‐6及IL‐17水平。结果益生菌组患者VAP发生率（26．1％）明显低于对照组（55．7％），差异有统计学意义（P＜0．05），并且益生菌组患者出现VAP的时间明显晚于对照组（P＜0．05），平均ICU住院时间方面，益生菌组也明显优于对照组（P＜0．05）。在治疗早期（治疗后第4天）益生菌组PCT、IL‐6、IL‐17水平均明显低于对照组（P＜0．05）。结论机械通气患者早期使用复合乳酸杆菌制剂可以有效预防VAP的发生。
목적：탐토조기응용복합유산균예방호흡궤상관폐염（VAP）적림상료효급기대백세포개소（IL）‐6화IL‐17수평적영향。방법련속성납입2014년1～12월ICU주원치료적230례중증환자，수궤평균분위익생균조화대조조。비교량조환자VAP발생솔、병사솔、림상치료효과급ICU주원시간등림상지표。동시분석비교강개소원（PCT）、IL‐6급IL‐17수평。결과익생균조환자VAP발생솔（26．1％）명현저우대조조（55．7％），차이유통계학의의（P＜0．05），병차익생균조환자출현VAP적시간명현만우대조조（P＜0．05），평균ICU주원시간방면，익생균조야명현우우대조조（P＜0．05）。재치료조기（치료후제4천）익생균조PCT、IL‐6、IL‐17수평균명현저우대조조（P＜0．05）。결론궤계통기환자조기사용복합유산간균제제가이유효예방VAP적발생。
Objective To investigate the clinical effect of compound lactobacillus for preventing ventilator as‐sociated pneumonia(VAP) and its influence on the levels of interleukin‐6(IL‐6) and interleukin‐17(IL‐17) .Methods 230 critical patients in ICU from January to December 2014 were consecutively enrolled in this study and randomly and equally divided into the probiotics group and the control group .The occurrence rate of VAP ,mortality rate ,clini‐cal curative effect and ICU duration were compared between the two groups .The levels of IL‐6 ,IL‐17 and PCT were analyzed and compared between these two groups .Results The occurrence rate of VAP in the probiotics group was 26 .1% ,which was significantly lower than 55 .7% in the control group ,the difference was statistically significant (P<0 .05) ,the time of VAP appearance in the probiotics group was significantly posterior to the control group (P<0 .05) ,and mean ICU duration in the probiotics group was significantly shorter than that in the control group (P<0 .05) .The levels of PCT ,IL‐6 and IL‐17 at the early stage in the probiotics group were significantly lower than those in the control group(P<0 .05) .Conclusion The early adiministration of compound lactobacillus in the patients with mechanical ventilation may effectively prevent the VAP ocurrence .