微生态制剂对肝硬化患者肠屏障功能影响及疗效观察  

Effect of Microbial Ecological Agent on the Function of Intestinal Mucosa Barrier in Cirrhosis Patients

作　　者：陈渝萍[1,2] 钟转华[1,2] 梁月环[1,2] 王安[1,2] 

机构地区：[1]暨南大学第三附属医院 [2]珠海市人民医院消化科,珠海519000

出　　处：《临床消化病杂志》2010年第4期204-207,共4页Chinese Journal of Clinical Gastroenterology

基　　金：珠海市科委立项科研课题资助。编号200701036-PC20091005

摘　　要：目的探讨微生态制剂在改善肝硬化患者肠黏膜通透性、血内毒素水平、肠道菌群状态方面的作用及对肝硬化预后的影响。方法选择肝硬化患者57例,随机分为对照组25例,试验组32例,两组均采用常规护肝利尿治疗,试验组在此基础上,加用双歧杆菌三联活菌胶囊治疗8周,测定两组治疗前后肠道10种细菌菌落数、内毒素水平及尿乳果糖/甘露醇比值的变化。结果 (1)治疗后试验组内毒索水平、尿乳果糖/甘露醇比值明显低于治疗前及对照组治疗后水平,P<0.05。(2)试验纽治疗后肠道双歧杆菌、乳杆菌菌落数明显高于治疗前及对照组治疗后水平,P<0.05。(3)试验组治疗后并发症发生率明显低于治疗前,P<0.05;对照组治疗前后上述检测值无明显变化,P>0.05。结论微生态制剂通过调节肠道菌群状态,改善肠道机械屏障功能,降低肝硬化患者肠黏膜通透性,从而避免内毒素及细菌移位对器官功能的影响,对降低肝硬化并发症发生率、改善患者的预后具有重要的临床意义。Objective To investigate the effect of microecological agents in improving the permeability of intestinal mucosa,the levels of endotoxin and the condition of intestina with hepatocirrhosis.Method 57 hepatocirrhosis cases were selected and rando mly divided into control group 25 cases and experimental group 32 cases,both of which adopt regular therapy in liver protection and diuresis.Upon this basis,the experimental group are given bifid triple viable capsule for 8 weeks.Colonies of 10 bacteria are counted,endotoxin levels tested and the alteration of urine lactulose/mannitol ratio（L/MR）were observed on both groups prior and post the treatment.Resulty（1）The endotoxin levels and L/MR of experimental group after treatment are significantly lower than the counter-part before treatment,as well as the levels of the control group after treatment,P〈0.05.（2）The number of bifidobacteria colonies and lactobacillus colonies of experimental group are significantly largerthan the counter-part prior treatment and those in control group post treatment,P〈0.05.（3）The incidence of complication of the experimental group displays significant declination after treatment,P〈0.05.While no obvious difference is observed in control group prior and posttreatment.Conclusion The microecological agents can regulate the condition of intestina flora,improve the barrier function of intestine,and weaken the permeability of intestinal mucosa,thereby ridding the effect endotoxin and gut bacterial translocation exerting on the function of organs,which leads to the clinical significance microecological preparation has on lower the incidence of complication and prognosis improvement in hepatocirrhosis treatment.

关 键 词：肝硬化 肠黏膜通透性 内毒素 肠道菌群 微生态制剂 

分 类 号：R575.2[医药卫生—消化系统]