Department of Gastroenterology and Human nutrition unit, All India Institute of Medical Sciences, New Delhi, India.
J Clin Gastroenterol. 2011 May-Jun;45(5):442-8. doi: 10.1097/MCG.0b013e318201f9e2.
To study the role of probiotics on gut permeability and endotoxemia in patients with acute pancreatitis (AP).
Bacterial translocation has been implicated in infective complications in AP, which has been shown to be prevented by probiotics.
A double-blind, randomized placebo-controlled trial was conducted. Consecutive patients with AP presenting within 72 hours after the onset of abdominal pain or who had been nil orally at the time of presentation for up to 5 days were included in the study. The probiotic group received 4 sachets of Probiotics (2.5 billion bacteria per sachet) whereas the placebo group received 4 sachets of placebo for 7 days. Primary outcome measures were effect on gut permeability [assessed by lactulose/mannitol (L/M) excretion in urine] and endotoxemia assessed by endotoxin-core antibody types IgG and IgM (EndoCab IgG and IgM). Secondary outcome measures were mortality, total hospital/intensive care unit stay, abdominal discomfort, organ failure, C-reactive protein, and prealbumin levels. The study was prematurely stopped after the publication of probiotic prophylaxis in patients with predicted severe acute pancreatitis trial.
From March 2007 to May 2008, 50 patients with AP were included in the study (26 in placebo group and 24 in probiotic group). There was no difference after intervention in gut permeability, whereas values of C-reactive protein and immunoglobulins decreased significantly [IgG: 140 (20-920) to 90 (20-600) GGU/mL and IgM: 65 (13-230) to 51 (9-240) GMU/mL] in the probiotic group. No difference was observed in prealbumin values, duration of hospital/intensive care unit stay, and mortality in both the groups.
No significant trend was identified for an effect of probiotics on gut permeability or endotoxemia in AP. However, the study was underpowered owing to premature study termination.
研究益生菌对急性胰腺炎（AP）患者肠道通透性和内毒素血症的作用。
细菌易位与 AP 的感染性并发症有关，益生菌已被证明可预防这种并发症。
进行了一项双盲、随机安慰剂对照试验。连续纳入腹痛发作后 72 小时内或就诊时已禁食超过 5 天的 AP 患者。益生菌组接受 4 袋益生菌（每袋 25 亿个细菌），而安慰剂组接受 4 袋安慰剂，共 7 天。主要观察指标是对肠道通透性（通过尿中乳果糖/甘露醇（L/M）排泄评估）和内毒素血症（通过内毒素核心抗体 IgG 和 IgM（EndoCab IgG 和 IgM）评估）的影响。次要观察指标是死亡率、总住院/重症监护病房停留时间、腹部不适、器官衰竭、C 反应蛋白和前白蛋白水平。在预测性重症急性胰腺炎试验中发表益生菌预防后，该研究提前停止。
2007 年 3 月至 2008 年 5 月，共纳入 50 例 AP 患者（安慰剂组 26 例，益生菌组 24 例）。干预后肠道通透性无差异，而 C 反应蛋白和免疫球蛋白值显著下降[IgG：140（20-920）至 90（20-600）GGU/mL 和 IgM：65（13-230）至 51（9-240）GMU/mL]。两组前白蛋白值、住院/重症监护病房停留时间和死亡率均无差异。
益生菌对 AP 患者肠道通透性或内毒素血症无显著影响趋势。然而，由于研究提前终止，该研究的效力不足。
