微生态制剂对肝硬化患者肠道菌群及内毒素水平干预疗效观察  

Study on the effect of micro-ecologial agents in the intestinal flora and endotoxin level of patients with liver cirrhosis

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,广东珠海519000

出　　处：《右江医学》2010年第6期659-661,共3页Chinese Youjiang Medical Journal

基　　金：珠海市科委立项科研课题资助(编号:200701036-PC20071005)

摘　　要：目的探讨微生态制剂对肝硬化患者肠道菌群、内毒素水平的干预作用及疗效。方法选择肝硬化患者57例,另选取24例健康体检者作为健康组,将57例肝硬化患者随机分为对照组25例,观察组32例,两组均采用常规护肝利尿治疗,观察组在此基础上,加用双歧杆菌三联活菌胶囊治疗8周,分别测定治疗前各组及治疗后两疾病组肠道10种细菌菌落数和内毒素水平。并对比两疾病组治疗前后并发症的变化情况。结果治疗前肝硬化患者的内毒素水平显著高于健康体检者(P<0.01),肠道菌群中的双歧杆菌、乳杆菌、肠杆菌显著低于健康体检者(P<0.05或0.01),葡萄球菌、梭菌显著高于健康体检者(P<0.01)。治疗前两疾病组内毒素水平及各肠道菌群菌落数比较差异无统计学意义(P均>0.05),治疗后对照组内毒素水平无显著变化(P>0.05),观察组内毒素水平显著低于治疗前(P<0.01);对照组中肠杆菌、真杆菌较治疗前显著下降(P<0.05或0.01),观察组中肠杆菌、双歧杆菌、乳杆菌、拟杆菌较治疗前显著升高,葡萄球菌、梭菌较治疗前显著降低(P<0.05或0.01),其中治疗后观察组的双歧杆菌、乳杆菌菌落数显著高于对照组(P<0.05或0.01)。治疗前后比较,观察组的并发症发生率显著降低(P<0.01),对照组无改变。结论微生态制剂能调节肠道菌群状态,提高肠道有益菌如双歧杆菌含量,降低内毒素水平,对降低肝硬化并发症发生率、改善预后具有重要的临床意义。Objective To investigate the effect of micro-ecological agents on the intestinal flora and endotoxin level of patients with liver cirrhosis.Methods 57 patients with liver cirrhosis and 24 healthy participants were chosen.57 patients with cirrhosis were randomly divided into control group（25 cases） and treatment group（32 cases）,both groups were treated with conventional diuretic liver,the treatment group was added bifidobacterium triple viable capsule for 8 weeks.10 colonies number and endotoxin levels were measured in three groups pre and post treatment.Results Endotoxin levels in cirrhotic patients was significant higher than healthy group（P〈0.01）,the colonies number of bifidobacteria,Lactobacillus and enterobacteriaceae in the intestinal flora were significant lower than healthy group（P〈0.05 or 0.01）,the colonies number of staphylococcus aureus and Fusobacterium was significant higher than healthy group before treatment（P〈0.01）.Endotoxin levels and the number of colonies of intestinal flora was no significant difference before treatment（P〈0.05）,there was no significant difference of the levels of endotoxin in the control group after treatment（P〈0.05）,while the level of Endotoxin in the treatment group was significantly lower（P〈0.01）;the level of Enterobacteriaceae and Eubacterium was significant lower in control group（P〈0.05 or 0.01）,the level of Bifidobacterium,Lactobacillus and Eubacterium increased significantly,staphylococci were significant lower in treatment group（P〈0.05 or 0.01）,while the colony count of Bifidobacterium and Lactobacillus bacteria were significant larger in treatment group（P〈0.05 or 0.01）.The complication rate of the treatment group were significantly lower after treatment comparing to before treatment（P〈0.01）,no change was found in control group.Conclusion Micro-ecological agents can effectively regulate the condition of intestinal flora,enhancing the content of beneficial bacterium,such as bifidobacteria,declining the l

关 键 词：内毒素 肠道菌群 微生态制剂 肝硬化 

分 类 号：R575.2[医药卫生—消化系统]