熊去氧胆酸联合微生态制剂治疗原发性胆汁性胆管炎患者对肠道菌群的影响  

Effect of ursodeoxycholic acid and microecological agents on intestinal flora in patients with primary biliary cholangitis

作　　者：齐敬聪 邢文静 杜洋 高辰玮[2] Qi Jingcong;Xing Wenjing;Du Yang(Department of Gastroenterology,Infectious Disease Hospital,Zhangjiakou 075000,Hebei Province,China)

机构地区：[1]河北省张家口市传染病医院消化科,075000 [2]河北北方学院附属第一医院B超室

出　　处：《实用肝脏病杂志》2020年第4期524-527,共4页Journal of Practical Hepatology

基　　金：河北省自然科学基金资助项目(编号:E2016402017)。

摘　　要：目的研究熊去氧胆酸(UDCA)联合微生态制剂治疗原发性胆汁性胆管炎(PBC)患者对粪肠道菌群的影响。方法2017年6月~2019年6月我院收治的128例PBC患者被随机分为两组,每组64例,分别给予UDCA和UDCA联合双歧杆菌三联活菌肠溶胶囊治疗24周。采用实时荧光定量PCR法检测粪肠道菌群,采用放射免疫分析法测定血清肿瘤坏死因子-α(TNF-α),采用ELISA法测定血清白介素2(IL-2)、IL-6、IL-17和IL-22水平。结果治疗后,观察组粪双歧杆菌和拟杆菌菌落数分别为(8.7±0.9)lg CFU/g和(8.9±0.9)lg CFU/g,显著高于对照组【分别为(8.0±0.6)lg CFU/g和(8.1±0.6)lg CFU/g,P<0.05】,而酵母样真菌和大肠埃希菌菌落数分别为(4.3±0.7)lg CFU/g和(8.7±0.6)lg CFU/g,显著低于对照组【分别为(5.1±0.7)lg CFU/g和(9.2±0.7)lg CFU/g,P<0.05】;治疗后,观察组血清TNF-α、IL-2、IL-6、IL-17和IL-22水平分别为(5.9±1.6)pg/ml、(65.5±12.6)pg/ml、(5.6±1.1)pg/ml、(7.6±2.3)pg/ml和(17.5±2.7)pg/ml,显著低于对照组【分别为(7.0±2.1)pg/ml、(85.7±20.1)pg/ml、(6.7±1.5)pg/ml、(9.2±3.2)pg/ml和(23.3±4.4)pg/ml,P<0.05】;治疗后,观察组血清HA、Ⅳ-C和PⅢP水平分别为(113.2±24.1)μg/L、(145.5±19.8)μg/L和(134.6±21.5)μg/L,显著低于对照组【分别为(168.4±47.2)μg/L、(178.4±51.7)μg/L和(170.5±48.2)μg/L,P<0.05】。结论应用UDCA联合微生态制剂能有效纠正PBC患者肠道菌群失调,调节血清细胞因子水平,缓解肝纤维化程度。Objective The aim of this study was to observe the effects of ursodeoxycholic acid(UDCA)and microecological agents on intestinal flora in patients with primary biliary cholangitis(PBC).Methods 128 patients with PBC were admitted to our hospital from June 2017 through June 2019,and were randomly divided into two groups,with 64 cases in each group.The patients in the control group were treated with UDCA,and those in the observation group were treated with UDCA and microecological agent combination for 24 weeks.The fecal flora were detected by PCR,and serum tumor necrosis factor-α(TNF-α),interleukin-2(IL-2),IL-6,IL-17 and IL-22 as well as serum hyaluronic acid(HA),laminin(LN),collagen typeⅣ(Ⅳ-C)and procollagen-Ⅲ-peptide(PⅢP)were assayed respectively.Results At the end of the treatment,the fecal colonies of bifidobacteria and bacteroides in the observation group were(8.7±0.9)lg CFU/g and(8.9±0.9)lg CFU/g,respectively,significantly higher than[(8.0±0.6)lg CFU/g and(8.1±0.6)lg CFU/g,respectively,P<0.05],while the colonies of yeast-like fungi and escherichia coli were(4.3±0.7)lg CFU/g and(8.7±0.6)lg CFU/g,significantly lower than[(5.1±0.7)lg CFU/g and(9.2±0.7)lg CFU/g,respectively,P<0.05]in the control;serum TNF-α,IL-2,IL-6,IL-17 and IL-22 in the observation group were(5.9±1.6)pg/ml,(65.5±12.6)pg/ml,(5.6±1.1)pg/ml,(7.6±2.3)pg/ml and(17.5±2.7)pg/ml,significantly lower than[(7.0±2.1)pg/ml,(85.7±20.1)pg/ml,(6.7±1.5)pg/ml,(9.2±3.2)pg/ml and(23.3±4.4)pg/ml,P<0.05]in the control group;serum HA,Ⅳ-C and PⅢP were(113.2±24.1)μg/L,(145.5±19.8)μg/L and(134.6±21.5),significantly lower than[(168.4±47.2)μg/L,(178.4±51.7)μg/L and(170.5±48.2)μg/L,respectively,P<0.05]in the control.Conclusion Ursodeoxycholic acid and microecological agents combination regimen might effectively correct intestinal flora imbalance,regulate serum cytokines and alleviate the degree of liver fibrosis in patients with PBC.

关 键 词：原发性胆汁性胆管炎 熊去氧胆酸 微生态制剂 肠道菌群 治疗 

分 类 号：R575.7[医药卫生—消化系统]