title: [Impact of microbial immune enteral nutrition on postoperative insulin resistance and infectious complication of patients with abdominal infection].
abstract: OBJECTIVE
  To investigate the effect of microbial immune enteral nutrition composed of probiotics, deep sea fish oil, glutamine and nutrison on postoperative immune status, insulin resistance and infectious complication morbidity in patients with abdominal infection.
  
  
  METHODS
  From September 2010 to April 2013 in Shandong Liaocheng City Hospital, 96 patients with upper gastrointestinal perforation were prospectively randomized into the treatment group (microbial immune enteral nutrition, n=48) and the control group(conventional enteral nutrition, n=48). Number of T cell subsets (CD3(+), CD4(+), CD8(+), CD4(+)/CD8(+)) and natural killer (NK) cell, procalcitonin (PCT), fasting blood glucose (FBG), fasting insulin (FINS), insulin resistance index (InHOMA-IR) calculated by the homeostasis model assessment(HOMA) were detected before operation and on days 3 and 7 after operation and compared between the two groups. The incidence of postoperative infectious complication was collected and compared as well.
  
  
  RESULTS
  There were no significant differences in immune indexes and insulin resistance-associated indexes between the two groups before operation and on the day 3 after operation(all P>0.05). On postoperative day 7, CD4(+), CD4(+)/CD8(+) and NK cells in treatment group were significantly higher than those in control group [(39.1±4.3)% vs. (30.1±5.7)%, P=0.043; 1.76±0.21 vs. 1.36±0.12, P=0.038; (19.3±4.8)% vs. (13.3±3.2)%, P=0.032], while FINS, lnHOMA-IR and PCT in treatment group were significantly lower than those in control group [(7.3±1.7) mU/L vs. (10.2±2.1) mU/L, P=0.041; 0.60±0.05 vs. 0.88±0.06, P=0.039; (0.12±0.07) μg/L vs. (0.35±0.12) μg/L, P=0.028]. Postoperative infectious complication morbidity was significantly lower in treatment group as compared to control group [18.8%(9/48) vs. 39.6%(19/48), P=0.025].
  
  
  CONCLUSIONS
  Microbial immune enteral nutrition composed of probiotics, deep sea fish oil, glutamine and nutrison can improve the immune status, decrease the level of insulin resistance, and reduce the incidence of postoperative infectious complication for patients with abdominal infection due to upper gastrointestinal perforation.
authors: Department of General Surgery, Liaocheng City Hospital, Shandong Liaocheng 252000, China. xinfeng8899@126.com.
authors: Feng
authors: F
authors: Shao
authors: Daogui
authors: D
authors: Yang
mesh_terms: D000007:Abdominal Injuries; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide; D004750:Enteral Nutrition; D005395:Fish Oils; D005973:Glutamine; D006801:Humans; D007333:Insulin Resistance; D007694:Killer Cells, Natural; D011183:Postoperative Complications / Q000276:immunology* / Q000382:microbiology / Q000517:prevention & control; D011184:Postoperative Period; D019936:Probiotics; D011498:Protein Precursors; D016176:T-Lymphocyte Subsets
chemical_list: C000606589:CALCA protein, human; D005395:Fish Oils; D011498:Protein Precursors; D005973:Glutamine; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide