调整肠道菌群对肝硬化患者血浆内毒素及肝功能的影响  

The influence of intestinal microflora regulation on plasma endotoxin and liver function in patients with liver cirrhosis

作　　者：宋爱玲[1] 江海[1] 郭玉婷[1] 

机构地区：[1]山东中医药大学第二附属医院消化科,山东济南250001

出　　处：《胃肠病学和肝病学杂志》2010年第8期746-748,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的观察肝硬化患者口服益生菌制剂前后肠道菌群、血浆内毒素及肝功能指标的变化。方法选择肠道菌群中具有代表性的细菌共5种进行培养和计数。56例肝硬化失代偿期患者随机分成2组,益生菌组(治疗组)28例,对照组28例,对照组给予常规治疗,治疗组在常规治疗的基础上给予益生菌治疗,疗程14 d。测定治疗前后肠道菌群菌落计数、血浆内毒素水平及肝功能指标。另选择30例正常人为正常对照组。结果与正常对照组相比,肝硬化组患者存在不同程度的肠道菌群失调,主要表现为双歧杆菌减少(10.19±0.72vs9.13±1.01,P<0.05),治疗后治疗组双歧杆菌、乳杆菌、肠球菌[(12.28±1.02)lg CFU/g、(11.17±1.18)lg CFU/g、(11.56±1.27)lg CFU/g]较治疗前[(9.39±1.23)lg CFU/g、(9.26±1.13)lg CFU/g、(8.57±1.45)lg CFU/g]明显增加(P<0.05),血浆内毒素则明显低于对照组[(0.082±0.031)EU/mLvs(0.145±0.047)EU/mL,P<0.05],肝功能指标明显好于对照组(P<0.05)。结论肝硬化患者存在肠道菌群失调。益生菌制剂可有效改善肝硬化患者肠道菌群失调,并降低血浆内毒素水平,改善患者的肝功能,可作为肝硬化患者的辅助用药。Objective To investigate the changes in intestinal flora,plasma endotoxin and liver function after probiotics administration. Methods Five representive types of bacteria were cultured and counted.Fifty-six patients with decompensated cirrhosis were randomly divided into two groups.The probiotic group（treatment group） enrolled 28 cases and the control group enrolled 28 cases. Conventional treatment was provided to control group.The treatment group was provided probiotics as supplements to conventional treatment for 14 days.Fecal flora,plasma endotoxin and liver function were measured before and after treatment.Thirty healthy controls were also enrolled. Results Patients with liver cirrhosis had varying degrees of intestinal flora reduction.It was shown that bifidobacterium significantly decreased（10.19±0.72 vs 9.13±1.01,P0.05）.The count of bifidobacterium,lactobacillus and enterococcus significantly increased after treatment [（12.28±1.02） lg CFU/g,（11.17±1.18） lg CFU/g,（11.56±1.27） lg CFU/g vs（9.39±1.23） lg CFU/g,（9.26±1.13） lg CFU/g,（8.57±1.45） lg CFU/g,P0.05].The level of endotoxin were significantly lower in the probiotics groups than that in control group [（0.082±0.031） EU/mL vs（0.145±0.047） EU/mL,P0.05].The liver function was significantly better in treatment group than that in control group（P0.05）. Conclusion Patients with liver cirrhosis have imbalances of intestinal flora.Probiotics can ameliorate imbalances of intestinal flora reduce the level of endotoxin and improve the liver function of patients effectively.Thus,it could be used as a supplement for patients with liver cirrhosis.

关 键 词：肝硬化 肠道菌群 内毒素类 肝功能 益生菌 

分 类 号：R735.2[医药卫生—肿瘤]