益生菌对肝硬化患者肠黏膜通透性的影响  

Bifico improves intestinal macromolecular permeability in patients with liver cirrhosis

作　　者：范妮[1] 田字彬[1] 孔心涓[1] 赵清喜[1] 魏良洲[1] 

机构地区：[1]青岛大学医学院附属医院消化科,山东省青岛市266003

出　　处：《世界华人消化杂志》2009年第36期3745-3748,共4页World Chinese Journal of Digestology

摘　　要：目的:探讨肝硬化门脉高压患者肠黏膜屏障功能及双歧杆菌等三联活菌胶囊(培菲康)对肝硬化患者肠黏膜通透性的影响.方法:选择我院肝硬化门脉高压、肝功能Child-pugh分级为B级的患者34例,随机分为对照组和双歧杆菌等三联活菌胶囊(培菲康)治疗组,两组均给予常规对症治疗,治疗组加用培菲康,每次420mg,每日3次,口服2wk.所有患者均于治疗前后测定血清二胺氧化酶(DAO)及内毒素(ETX)含量.另选12例健康体检者作为正常对照组.结果:肝硬化患者治疗组及对照组血清DAO及ETX含量均高于正常对照组,差异有统计学意义(0.2502±0.0969kU/L,0.2263±0.1145kU/L vs 0.1145±0.0680kU/L,P<0.01;0.3801±0.1929EU/mL,0.3283±0.1251EU/mL vs 0.2338±0.0843EU/mL,均P<0.05);血清DAO及ETX两指标呈线性相关(r=0.800,P<0.01);培菲康组治疗后血清DAO及ETX水平较治疗前下降,差异均有统计学意义(0.1635±0.0592kU/L vs 0.2502±0.0969kU/L,0.2445±0.1219EU/mL vs 0.3801±0.1929EU/mL,P<0.05);对照组治疗后血清DAO及ETX水平较治疗前下降,但差异无统计学意义.结论:血清DAO及ETX水平可作为肝硬化Child-pugh分级B级患者肠黏膜屏障功能的监测指标;补充肠道益生菌可帮助改善肠黏膜屏障功能.AIM： To evaluate the effects of Bifico （live Bifidobacterium, Lactobacillus and Enterococcus, oral capsules） on the intestinal mucosal barrier in patients with liver cirrhosis. METHODS： Thirty-four patients with portal hypertension and liver cirrhosis （Child-Pugh grade B） were randomly divided into two groups： patients receiving only routine symptomatic treatment （routine treatment group） and those receiving both routine symptomatic treatment and oral Bifico capsules 420 mg, three times daily for 2 weeks （Bifico treatment group）. A normal control group was composed of 12 healthy individuals. Plasma diamine oxidase （DAO） and endotoxin （ETX） were detected before and after the therapy. RESULTS： Plasma DAO and ETX levels were significantly higher （0.2502±0.0969 kU/L and 0.2263±0.1145 kU/L vs 0.1145±0.0680 kU/L;and 0.3801±0.1929 EU/mL and 0.3283±0.1251 EU/mL vs 0.2338±0.0843 EU/mL, respectively; all P 〈 0.05 or 0.01） in patients with liver cirrhosis （the two treatment groups） than in healthy individuals （the normal control group）. A linear correlation was noted in plasma ETX level and plasma DAO level （r=0.800, P 〈 0.01）. Compared with pre-treated patients, both plasma DAO and ETX levels significantly decreased in Bifico-treated patients （0.1635±0.0592 kU/L vs 0.2502±0.0969 kU/L, 0.2445±0.1219 EU/mL vs 0.3801±0.1929 EU/mL, P 〈 0.05）. No significant differences were noted in plasma DAO and ETX levels in the routine treatment group between before and after therapy. CONCLUSION： Plasma DAO and ETX are sensitive markers for measuring intestinal barrier function in patients with liver cirrhosis. Bifico can improve intestinal barrier function in patients with portal hypertension and liver cirrhosis.

关 键 词：肝硬化 肠黏膜屏障 培菲康 二胺氧化酶 内毒素 

分 类 号：R575.2[医药卫生—消化系统] R473.73[医药卫生—内科学]