探讨激素联合美沙拉秦对溃疡性结肠炎患者肠道微生态和肠道屏障功能的影响  

作　　者：王振疆 陈渝萍[1] 黄剑迎[1] 梁月环[1] 

机构地区：[1]暨南大学附属珠海医院消化内科,519000

出　　处：《浙江临床医学》2016年第8期1375-1377,共3页Zhejiang Clinical Medical Journal

基　　金：广东省珠海市科技计划项目[珠科工贸信计（2012）8号]

摘　　要：目的探讨激素地塞米松保留灌肠联合美沙拉秦13＇服对溃疡性结肠炎（UC）患者肠道微生态和肠道屏障功能的影响及其临床意义。方法选择40例轻中度活动期UC患者，随机分为联合组与美沙拉秦组，每组各20例，选择20位健康体检者作为对照组。联合组予地塞米松保留灌肠联合美沙拉秦口服治疗，美沙拉秦组予美沙拉秦口服，疗程均为4周。分析治疗前后患者临床症状及肠道菌群、肠黏膜通透性的改变。结果治疗前两组患者较对照组均存在不同程度的肠道菌群紊乱和肠黏膜通透性增加（P〈O．05）。联合组治疗后肠杆菌、酵母菌和梭菌高于对照组，而双歧杆菌等依然低于对照组（P〈O．05）；美沙拉秦组治疗后酵母菌、乳杆菌均恢复常态，其余菌群低于对照组（P〈O．05）。两组患者治疗后尿乳果糖／甘露醇（L／M）比值均较治疗前降低（P〈O．05）。结论激素联合美沙拉秦治疗uc能迅速诱导临床缓解、改善肠黏膜通透性，但长期使用激素可能会加重肠道菌群紊乱风险。Objective To study the influences of hormone Dexamethasone retention enema combined with Mesalazine being taken orally on intestinal microecology and intestinal barrier functions of ulcerative colitis patients and its significance. Methods 40 cases of UC patients in mild-to- moderate activity period are chosen and are randomly divided into combination group and Mesalazine group. 20 healthy physical examinees are selected as control group, combination group is treated with Dexamethasone retention enema combined with Mesalazine being taken orally. The Mesalazine group is treated with Mesatazine being taken orally. The treatment course of both group are 4 weeks. The clinical symptoms, changes of intestinal flora and intestinal barrier functions of patients before and after treatment were analyzed. Results Compared with control group, both the two groups of patients had symptoms of different degree of disorder of intestinal flora and intestinal mucous membrane permeability increasing before treatment. （ P〈0.05 ） . In combination group after the treatment, the enterobacteria, microzyme and clostridium are higher than the healthy group, but the Bifidobacterium is still lower than the control grou （ P〈0.05 ） ; In Mesalazine group after treatment the microzyme and Lactobacillus return normal, while the others are still lower than the healthy group （ P〈0.05 ） .The lactulose/mannitol （ L/M ） ratio of both group after treatment are lower than that before treatment （ P〈0.05 ） . Conclusion Hormone retention enema combined with Mesalazine can quickly induce UC clinically ease and reduce the permeability of intestinal mucosa, but the long-term use of hormones may have increased risk of intestinal flora disorder.

关 键 词：溃疡性结肠炎 激素 美沙拉秦 肠道微生态 肠屏障功能 

分 类 号：R174.4[医药卫生—妇幼卫生保健]