补充微生态制剂对腰椎后路手术患者肠道菌群失调的影响  

Effect of micro-ecological agent on the intestinal dysbacteriosis of patients with posterior lumbar spinesurgery

作　　者：邓仲元[1] 谭小青[1] 贺德行[1] 王璞[1] 刘世学[1] 窦宇红[2] 江振华[1] 

机构地区：[1]广州医科大学附属深圳沙井医院骨科,518104 [2]广州医科大学附属深圳沙井医院细菌室,518104

出　　处：《中国综合临床》2014年第1期10-14,共5页Clinical Medicine of China

摘　　要：目的探讨微生态制剂金双歧对腰椎后路手术患者肠道菌群的影响。方法72例腰椎后路手术患者，出现肠道菌群失调症者42例作为实验组（A组），未出现肠道菌群失调症的30例作为对照组（B组）。两组患者术前、术后检测血浆内毒素、血清肿瘤坏死因子or．（TNF—a）及白细胞介素6（IL-6）。肠道菌群失调症者术后另加用金双歧。术前、术后第1次自然排便（术后1—4d）时分别留取粪便标本，比较两组患者肠道主要菌群差异、双歧杆菌（B）／肠杆菌（E）值。结果术前、术后第2、7天A、B两组患者血浆内毒素水平分别为（1．82±0．12）、（2．29±0．15）、（1．91±0．08）ng／L和（1．91±0．21）、（2．35±0．16）、（2．26±0．24）ng／L。TNF—d分另0为（275±51）、（309±45）、（276士34）ng／I~和（269±48）、（318±67）、（297±53）ng／L；IL-6分另0为（1384-22）、（159±15）、（137±17）ng／L和（159±16）、（187±19）、（174±21）ng／L。经重复测量方差分析显示，血浆内毒素、TNF-a、IL-63个指标组间、交互作用差异均有统计学意义（P均〈0．05），组内比较差异无统计学意义（P均〉0．05）。3个指标浓度均随着住院时间的延长而逐渐降低，术后第2、7天与术前比较差异均有统计学意义（P均〈0．05），且术后第7天与术后第2天比较差异也有统计学意义（P均〈0．05）。术后第2天A组血浆内毒素、TNF．仪、IL-6与B组比较差异均有统计学意义（P均〈0．05）；术后第7天，A组内毒素、TNF-仪、IL-6开始缓慢下降，与B组比较差异均有统计学意义（P均〈0．05）。术后A组肠道的双歧杆菌、类杆菌数量及B／E值较B组均减少，分别为（9．17±0．54）lgefu／g与（10．01±0．75）lgcfu／g，（9．23±0．47）lgcfu／g与（10．09±0．81）lgcfu／g，1．01±0．16与1．20-1-0．11，差异均有统计学意义（P值分�Objective To investigate the effect of micro-ecological agent on the intestinal flora of patients with posterior lumbar spine surgery. Methods Seventy-two patients with lumbar spine surgery were selected as our subjects. Of them, 42 patients with occurred the intestinal flora dysfunction were served as experimental group （group A）, other 30 patients were as control group （group B ）. The levels of plasma endotoxin,plasma tumor necrosis factor-o~ （TNF-ct）, Interleukin 6 （IL-6） were detected before and after operation. The patients in group A were treated with micro-ecological agent Jinshuangqi. Collected stool samples at preoperative, postoperative first natural defecation （after 1 -4 d）, and compared intestinal flora difference and Bifidobacterium （B）/Enterobacteriaceae （E） value of two groups patients. Results The levels of plasma endotoxin in group A were （ 1.82±0. 12）, （2. 29 ＋0. 15）, （ 1.91±0.08） ng/L at before surgery,the 2nd and 7th day after surgery, and that in group B were （ 1.91 ± O. 21 ）, （2. 35 ± 0. 16 ）, （2. 26 ± 0. 24） ng/L. The TNF- a level in group A were （275 _＋51） ,（309 _＋45） ,（276 ±34） ng/L and that in group B were （269±48） ,（318 ±67）, （297 ±53） ng/L at before surgery,the 2nd and 7th day after surgery. The IL-6 levels in group A were （ 138 ＋ 22 ）, （ 159 ± 15 ）, （ 137 ± 17 ） ng/L and that in group B were （ 159± 16 ）, （ 187 ± 19 ）, （ 174 ± 21 ） ng/L at before surgery, the 2nd and 7th day after surgery. The repeated measured repeated measures analysis of variance showed that among three indexes of plasma endotoxin, TNF-ot, IL-6 levels, differences of between group and interaction were statistically significant （ P 〈 0.05 ）, but there was no significant difference within groups （ P 〉 0. 05 ）. The levels of plasma endotoxin, TNF-a, IL-6 decreased after surgery ware gradually decreasing with hospitalization prolonged. There was significant difference between before su

关 键 词：肠道菌群失调 腰椎后路手术 微生态制剂 内毒素 

分 类 号：R687.3[医药卫生—骨科学]