title: [The effects of enteral nutrition versus total parenteral nutrition on gut barrier function in severe acute pancreatitis].
abstract: OBJECTIVE
  To evaluate the effect of enteral nutrition (EN) versus total parenteral nutrition (TPN) on gut barrier function in patients with severe acute pancreatitis (SAP).
  
  
  METHODS
  Sixty-three patients with SAP enrolled from 4 hospitals were randomly assigned into EN group (29 cases) and TPN group (34 cases). EN group patients were fed via a spiral nasojejunal feeding tube placed routinely by endoscopy or fluoroscopy, and TPN group patients were nourished intravenously with TPN during the same period. The changes of serum endotoxin, diamine oxidase, and urinary excretion of lactulose and mannitol ratio (L/M) were observed.
  
  
  RESULTS
  Plasma concentration of endotoxin were markedly decreased in EN group as compared with that in TPN group at the 7(th), 14(th), 21(th) day of entry trial [(39.30 ± 15.82) EU/L vs (73.05 ± 21.16) EU/L, (22.64 ± 14.31) EU/L vs (49.34 ± 24.54) EU/L, (14.81 ± 10.93) EU/L vs (30.08 ± 14.10) EU/L, P < 0.05]. Plasma concentration of diamine oxidase were markedly decreased in EN group as compared with that in TPN group at the 7(th), 14(th) day of entry trial [(9.97 ± 3.84) U/L vs (19.89 ± 9.89) U/L, (5.42 ± 1.84) U/L vs (8.79 ± 4.08) U/L, both P < 0.05]. The urinary L/M decreased significantly in EN group than those in TPN group at the 7(th), 14(th), 21(th) day of entry trial (0.28 ± 0.25 vs 0.65 ± 0.45, 0.21 ± 0.18 vs 0.54 ± 0.41, 0.08 ± 0.04 vs 0.29 ± 0.06, all P < 0.05).
  
  
  CONCLUSIONS
  EN has better effect on improving intestinal barrier function than TPN in treatment of patients with SAP.
authors.affiliation: Department of Gastroenterology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China. xcf601@163.com
authors.forename: Chun-fang
authors.initials: CF
authors.lastname: Xu
authors.forename: Xiao-xi
authors.initials: XX
authors.lastname: Huang
authors.forename: Yun-zhi
authors.initials: YZ
authors.lastname: Shen
authors.forename: Xing-peng
authors.initials: XP
authors.lastname: Wang
authors.forename: Lei
authors.initials: L
authors.lastname: Gong
authors.forename: Ya-dong
authors.initials: YD
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D004750:Enteral Nutrition; D005260:Female; D041981:Gastrointestinal Tract; D006801:Humans; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000503:physiopathology / Q000628:therapy*; D010289:Parenteral Nutrition, Total; D016896:Treatment Outcome; D055815:Young Adult