调节胆汁酸代谢及肠道菌群对非酒精性脂肪肝治疗效果研究  

Research on curative effects of regulating bile acid metabolism and intestinal flora in treatment of nonalcoholic fatty liver disease

作　　者：王菲[1] 王允野[1] 张丹[1] 赵晓茹 刘昆 WANG Fei;WANG Yunye;ZHANG Dan;ZHAO Xiaoru;LIU Kun(Department of Gastroenterology,Affiliated Hospital of Jilin Medical University,Jilin 132013,China)

机构地区：[1]吉林医药学院附属医院消化内科

出　　处：《中国医药科学》2019年第19期36-40,45,共6页China Medicine And Pharmacy

基　　金：吉林省吉林市医疗卫生指导性计划项目（201737145）

摘　　要：目的通过动物实验研究探讨调节饮食-胆汁酸-肠道菌群治疗非酒精性脂肪性肝病(NAFLD)的疗效。方法随机选择小鼠40只,分四组,每组10只,Ⅰ组采用普通饲料;Ⅱ组采用高脂饲料;Ⅲ组普通饲料,并给予头孢曲松钠。Ⅳ组高脂饲料,同时应用头孢曲松钠。喂养12周,采血化验甘油三酯(TG)、胆固醇(TC)、丙氨酸氨基转移酶(ALT)、谷氨酰氨基转移酶(AST)、胆汁酸(TBA)、脂联素、粪便胆汁酸水平,行肠道菌群培养比较,并测定肝匀浆组织血脂成分。根据Ⅳ组方式喂养小鼠32只,12周后均停用抗生素,给予普通饮食、无菌水,将其随机平均分为四组,每组8只,A组为对照组;B组给予熊去氧胆酸;C组给予枯草杆菌二联活菌;D组给予熊去氧胆酸及枯草杆菌二联活菌。ABCD四组小鼠均饲养12周后再次检测上述指标进行比较。结果Ⅱ、Ⅳ组小鼠,TG、ALT、AST、TBA、粪便胆汁酸水平均明显升高,差异有统计学意义(P<0.01)。Ⅲ组ALT、AST水平明显升高,差异有统计学意义(P<0.01)。B组ALT、AST、TBA,C组TG、ALT、AST、脂联素,D组TG、ALT、AST、TBA与A组比较,差异有统计学意义(P<0.05)。B、C、D组粪便胆汁酸水平较A组有明显变化,有统计学意义。各组与对照组比较肝匀浆血脂成分差异有统计学意义(P<0.05)。Ⅲ、Ⅳ组肠道菌群失调明显,双歧杆菌、乳酸杆菌、肠杆菌下降明显,肠球菌水平升高,差异有统计学意义(P<0.01)。C、D组肠道菌群改善明显,差异有统计学意义(P<0.01)。结论肠道菌群、胆汁酸代谢与NAFLD发生发展相关,通过调节肠道菌群及胆汁酸水平可以改善肝脏脂质代谢及肝功能,促进肝脏恢复。Objective To explore curative effects of regulating diet,bile acid and intestinal flora in treatment of nonalcoholic fatty liver disease(NAFLD)through animal experiments.Methods 40 mice were randomly selected and divided into four groups,with 10 mice in each group.GroupⅠwas given common fodder,groupⅡwas given high fat fodder,groupⅢwas given common fodder and ceftriaxone sodium and group IV was given high fat fodders and ceftriaxone sodium.After 12 weeks of feeding,blood samples were collected to analyze the levels of triglyceride(TG),cholesterol(TC),alanine aminotransferase(ALT),glutamine aminotransferase(AST),bile acid(TBA),adiponectin and fecal bile acid.The intestinal flora culture was compared,and the lipid composition of the liver homogenate was determined.32 mice were fed according to theⅣgroup.After 12 weeks,the antibiotics were stopped and the normal diet and sterile water were given.The mice were randomly divided into four groups,with 8 mice in each group.Group A was the control group,group B was given ursodeoxycholic acid,group C was given bacillus subtilis two combined live bacteria and group D was given ursodeoxycholic acid and bacillus subtilis two combined live bacteria.The mice in four groups of A,B,C and D were reared for 12 weeks and then the above indexes were tested again for comparison.Results TG,ALT,AST,TBA and fecal bile acid levels of mice were all significantly increased in groupⅡandⅣ(P<0.01),which was statistically significant.ALT and AST levels were significantly increased in groupⅢ(P<0.01),which was statistically significant.ALT,AST and TBA in group B,TG,ALT,AST and adiponectin in group C and TG,ALT,AST and TBA in group D were compared with group A(P<0.05),and there were statistically significant differences.The levels of fecal bile acids in group B,C and D were significantly different from those in group A,which was statistically significant.The blood lipid components of liver homogenate were compared with the control group(P<0.05),and there were statistically significant

关 键 词：非酒精性脂肪性肝病 胆汁酸 肠道菌群 益生菌 熊去氧胆酸 

分 类 号：R575.5[医药卫生—消化系统]