合生素补充联合生活方式干预对非酒精性脂肪肝病人肝硬化和免疫相关指标的影响  

Effect of synbiotic supplementary combined with lifestyle intervention on liver cirrhosis and immune related indexes in nonalcoholic fatty liver disease

作　　者：张珊 张伟[1] 李秀华[1] 董晴 王芳[2] ZHANG Shan;ZHANG Wei;LI Xiu-hua;DONG Qing;WANG Fang(Infectious Disease Department,321 Hospital Affiliated to Xi'an Jiaotong University,Hanzhong 723000,Shaanxi,China;Infectious Disease Department,Yan'an People's Hospital,Yanan 716000,Shaanxi,China)

机构地区：[1]西安交通大学附属三二〇一医院感染科,陕西汉中723000 [2]延安市人民医院感染科,陕西延安716000

出　　处：《肠外与肠内营养》2019年第5期286-291,共6页Parenteral & Enteral Nutrition

摘　　要：目的:评估补充合生素对NAFLD病人肝纤维化、肝酶和炎症标志物的影响。方法:通过随机、双盲、安慰剂对照的临床试验,对86例NAFLD病人进行初步研究,提供合生素或安慰剂胶囊,周期28周,每日两次。结果:结果表明,丙氨酸氨基转移酶(ALT)在两组中浓度均降低,且在合生素组更显著。在合生素组和安慰剂组还观察到以下显著差异ALT[-24.6(-28.5^-22.3)vs-6.7(-8.9^-4.6)IU/L,P<0.001],天冬氨酸转氨酶[-28.4(-31.5^-25.4)vs-5.7(-9.5^-3.1)IU/L,P<0.001],γ-谷氨酰转移酶[-12.95(-13.27^-12.82)vs-4.35(-5.17^-3.95)IU/L,P<0.001],高敏C反应蛋白[-2.42(-2.9^-1.7)vs-0.98(-1.34^-0.71)mmol/L,P<0.005],肿瘤坏死因子-α[-1.64(-1.93^-1.26)vs-0.72(-0.91^-0.43)mmol/L,P<0.001],总核因子κ-B p65[-0.023(-0.031^-0.016)vs-0.003(-0.006^-0.001)mmol/L,P<0.001],瞬时弹性成像评价纤维化[-2.76(-3.22^-2.18)vs-0.65(-1.16^-0.35)kPa,P<0.001]。结论:对NAFLD病人进行生活方式干预联合补充合生素优于单纯改善生活方式,作用机制可能是通过减弱体内炎症标志物来实现的。这些影响能否持续较长治疗时间仍有待确定。Objective:To evaluate the effects of supplementation of synbiotics on liver fibrosis,liver enzymes and inflammatory markers in the patients with NAFLD.Methods:A randomized,double-blind,placebo-controlled clinical trial was performed in 86 patients with NAFLD who were supplemented a synbiotic or placebo capsule for 28 weeks,twice daily.Results:The results showed that alanine aminotransferase(ALT)decreased in both groups and was more significant in the synbiotic group.The following significant differences were observed between the synbiotic group and placebo group ALT[-24.6(-28.5^-22.3)vs-6.7(-8.9^-4.6)IU/L,P<0.001],aspartate aminotransferase[-28.4(-31.5^-25.4)vs-5.7(-9.5^-3.1)IU/L,P<0.001],γ-glutamyltransferase[-12.95(-13.27^-12.82)vs-4.35(-5.17,-3.95)IU/L,P<0.001],high-sensitivity C-reactive protein[-2.42(-2.9^-1.7)vs-0.98(-1.34^-0.71)mmol/L,P<0.005],tumor necrosis factor-α[-1.64(-1.93^-1.26)vs-0.72(-0.91^-0.43)mmol/L,P<0.001],total nuclear factor κ-B p65[-0.023(-0.031^-0.016)vs-0.003(-0.006^-0.001)mmol/L,P<0.001],transient elastography to evaluate fibrosis[-2.76(-3.22^-2.18)vs-0.65(-1.16^-0.35)kPa,P<0.001].Conclusions:Lifestyle intervention with NAFLD combined with supplementation of synbiotics is superior to simple lifestyle improvement,and the mechanism may be achieved by attenuating inflammatory markers in vivo.Whether these effects can last longer is still to be determined.

关 键 词：合生素 非酒精性脂肪肝 生活方式 肝硬化 免疫指标 

分 类 号：R657.31[医药卫生—外科学]