益生菌治疗老年肺炎的临床疗效及其对炎性反应、细胞免疫功能的影响  

Clinical Effect of Probiotics in Treating Elderly Patients with Pneumonia and Its Impact on Inflammatory Reaction and Cellular Immune Function

作　　者：胡明[1] 李晓莉[1] 甄鹏 陈亚利 沈宝征 HU Ming;LI Xiaoli;ZHEN Peng;CHEN Yali;SHEN Baozheng(Department of Infectious Diseases,Beijing Luhe Hospital Affiliated to Capital Medical University,Beijing 101100,China)

机构地区：[1]首都医科大学附属北京潞河医院感染性疾病科

出　　处：《实用心脑肺血管病杂志》2019年第4期99-102,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的观察益生菌治疗老年肺炎的临床疗效,并分析其对炎性反应、细胞免疫功能的影响。方法选取2015年3月-2017年3月首都医科大学附属北京潞河医院感染性疾病科收治的老年肺炎患者120例,采用随机数字表法分为对照组和观察组,每组60例。对照组患者采用常规治疗,观察组患者在常规治疗基础上采用双歧杆菌四联活菌治疗;两组患者均连续治疗2周。比较两组患者临床疗效,治疗前及治疗2周后肺功能指标〔包括用力肺活量占预计值百分比(FVC%pred)、第1秒用力呼气容积占预计值百分比(FEV1%pred)及第1秒用力呼气容积占用力肺活量比值(FEV1/FVC)〕、肠道菌群〔包括乳酸杆菌、双歧杆菌、肠球菌及真杆菌〕,治疗前及治疗72 h后血清炎性因子〔包括白介素2(IL-2)、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)〕水平及T淋巴细胞亚群〔包括CD4+细胞分数、CD8+细胞分数及CD4+/CD8+细胞比值〕;观察两组患者治疗期间不良反应发生情况。结果(1)观察组患者临床疗效优于对照组(P<0.05)。(2)治疗前两组患者FVC%pred、FEV1%pred、FEV1/FVC比较,差异无统计学意义(P>0.05);治疗2周后观察组患者FVC%pred、FEV1%pred、FEV1/FVC高于对照组(P<0.05)。(3)治疗前两组患者肠道乳酸杆菌、双歧杆菌、肠球菌、真杆菌菌落数比较,差异无统计学意义(P>0.05);治疗2周后观察组患者肠道乳酸杆菌、双歧杆菌、肠球菌、真杆菌菌落数高于对照组(P<0.05)。(4)治疗前两组患者血清IL-2、IL-6、TNF-α水平及CD4+细胞分数、CD8+细胞分数、CD4^+/CD8^+细胞比值比较,差异无统计学意义(P>0.05);治疗72 h后观察组患者血清IL-2、IL-6、TNF-α水平及CD8^+细胞分数低于对照组,CD4+细胞分数、CD4^+/CD8^+细胞比值高于对照组(P<0.05)。(5)两组患者治疗期间均未发生明显不良反应。结论益生菌治疗老年肺炎的临床疗效确切,能有效改善患者肺功能、肠道菌群及细胞�Objective To observe the clinical effect of probiotics in treating elderly patients with pneumonia,to analyze its impact on inflammatory reaction and cellular immune function. Methods From March 2015 to March 2017,a total of 120 elderly patients with pneumonia were selected in the Department of Infectious Diseases,Beijing Luhe Hospital Affiliated to Capital Medical University,and they were equally divided into control group and observation group according to random number table method,with 60 cases in each group. Patients in control group received routine treatment,while patients in observation group received Bifidobacterium Tetragenous Viable Bacteria Tablets based on routine treatment;both groups continuously treated for 2 weeks. Clinical effect,index of pulmonary function(including FVC%pred,FEV1%pred and FEV1/FVC ratio)and intestinal flora(including Lactobacillus,Bifidobacterium,Enterococcus and Eubacterium ruminantium)before treatment and 2 weeks after treatmenet,inflammatory cytokines(including IL-2,IL-6 and TNF-α)and T-lymphocyte subsets(including CD4+ cell percentage,CD8+ cell percentage and CD4+/CD8+ cell ratio)before treatment and 72 hours after treatment were compared between the two groups,and incidence of adverse reactions was observed during treatment. Results(1)Clinical effect in observation group was statistically significantly better than that in control group(P<0.05).(2)No statistically significant difference of FVC%pred,FEV1%pred or FEV1/FVC ratio was found between the two groups before treatment(P>0.05),while FVC%pred,FEV1%pred and FEV1/FVC ratio in observation group were statistically significantly higher than those in control group 2 weeks after treatment(P<0.05).(3)No statistically significant difference of count of intestinal Lactobacillus,Bifidobacterium,Enterococcus or Eubacterium ruminantium between the two groups before treatment(P>0.05),while counts of intestinal Lactobacillus,Bifidobacterium,Enterococcus and Eubacterium ruminantium in observation group were statistically significantl

关 键 词：肺炎 老年人 益生菌 炎性因子 细胞免疫功能 治疗结果 

分 类 号：R563.1[医药卫生—呼吸系统]