酒精性肝病患者血清LP、LPO、NOS水平和肠道菌群分布变化分析  

Changes of serum LP,LPO,NOS and intestinal flora distribution in patients with alcoholic liver diseases

作　　者：栗红江 何福亮 陈来印 Li Hongjiang;He Fuliang;Chen Laiyin(Department of Liver Diseases,Infectious Diseases Hospital,Baoding 071000,Hebei Province,China)

机构地区：[1]河北省保定市传染病医院肝六科,071000 [2]首都医科大学附属北京友谊医院肝病中心 [3]河北省保定市传染病医院全员质量管理办公室,071000

出　　处：《实用肝脏病杂志》2020年第4期536-539,共4页Journal of Practical Hepatology

基　　金：河北省科技厅科研基金资助项目(编号:2018117)。

摘　　要：目的分析酒精性肝病(ALD)患者血清脂肪酶(LP)、过氧化脂质(LPO)、一氧化氮合成酶(NOS)水平和肠道菌群分布的变化。方法2017年1月~2019年6月我院肝病科诊治的88例ALD患者,其中酒精性脂肪肝(AFL)患者36例,酒精性肝炎(AH)患者27例,酒精性肝硬化(ALC)患者25例,另选择同期健康体检者40例,检测血清LP、LPO和NOS水平,常规培养分离粪细菌,采用快速微生物检测系统行细菌鉴定,以菌落形成单位的对数值(lg CFU/g)表示菌群数。结果ALC组血清LP水平为(6.2±1.9)μg/L,显著高于AH组【(3.6±1.1)μg/L,P<0.05】或AFL组【(1.6±0.4)μg/L,P<0.05】或健康人【(1.1±0.2)μg/L,P<0.05】;ALC组血清LPO水平为(7.2±2.1)μmol/L,显著高于AH组【(4.7±1.6)μmol/L,P<0.05】或AFL组【(3.3±1.0)μmol/L,P<0.05】或健康人【(2.1±0.5)μmol/L,P<0.05】;ALC组血清NOS水平为(7.8±2.6)U/ml,显著高于AH组【(4.9±1.7)U/ml,P<0.05】或AFL组【(3.5±1.2)U/ml,P<0.05】或健康人【(1.3±0.4)U/ml,P<0.05】;ALC组粪菌种数为(20.7±1.1)种,显著低于AFL组【(30.9±1.8)种,P<0.05】或健康人【(31.7±2.5)种,P<0.05】;AH组菌种数为(21.4±1.2)种,显著低于AFL组或健康人(P<0.05);ALC组大肠埃希菌为(9.2±1.8)IgCFU/g,显著高于AH组【(8.3±1.4)IgCFU/g,P<0.05】或AFL组【(6.8±1.5)IgCFU/g,P<0.05】或健康人【(7.1±1.3)IgCFU/g,P<0.05】;ALC组粪肠球菌为(9.5±2.3)IgCFU/g,显著高于AFL组【(7.1±1.3)IgCFU/g,P<0.05】或健康人【(6.5±1.5)IgCFU/g,P<0.05】,AH组为(8.6±1.5)IgCFU/g,也显著高于健康人或AFL组(P<0.05);ALC组粪双歧杆菌为(6.3±0.7)IgCFU/g,显著低于AH组【(7.2±1.1)IgCFU/g,P<0.05】或AFL组【(7.9±1.4)IgCFU/g,P<0.05】或健康人【(8.5±1.4)IgCFU/g,P<0.05】。结论ALD患者存在血清LP、LPO和NOS水平增高和肠道微生态失调,随着病情加重或进展,这种变化越明显,值得临床认真对待。Objective The aim of this study was to analyze the changes of serum lipase(LP),lipid peroxide(LPO),nitric oxide synthase(NOS)and intestinal flora distribution in patients with alcoholic liver disease(ALD).Methods 88 patients with ALD【including alcoholic fatty liver(AFL)in 36,alcoholic hepatitis(AH)in 27 and alcoholic liver cirrhosis(ALC)in 25】and 40 healthy persons were recruited in our hospital between January 2017 and June 2019,were serum LP,LPO and NOS levels were detected.The intestinal bacteria species and the numbers of major intestinal bacteria were separated and characterized.Results Serum LP level in patients with ALC was(6.2±1.9)μg/L,significantly higher than[(3.6±1.1)μg/L,P<0.05]in patients with AH,or[(1.6±0.4)μg/L,P<0.05]in patients with AFL,or[(1.1±0.2)μg/L,P<0.05]in healthy control group;serum LPO level in ALC group was(7.2±2.1)μmol/l,much higher than[(4.7±1.6)μmol/l,P<0.05]in AH group,or[(3.3±1.0)μmol/l,P<0.05]in AFL group,or[(2.1±0.5)μmol/l,P<0.05]in healthy control;serum NOS level in ALC group was(7.8±2.6)U/ml,significantly higher than[(4.9±1.7)U/ml,P<0.05]in AH group,or[(3.5±1.2)U/ml,P<0.05]in AFL group,or[(1.3±0.4)U/ml,P<0.05]in healthy control;the fecal bacteria strains in ALC group was(20.7±1.1),much lower than[(30.9±1.8),P<0.05]in AFL group,or[(31.7±2.5),P<0.05]in healthy control,while the bacteria strains in AH group was(21.4±1.2),significantly lower than in AFL or in healthy control group(P<0.05);the number of Escherichia coli in ALC group was(9.2±1.8)IgCFU/g,significantly higher than[(8.3±1.4)IgCFU/g,P<0.05]in AH group,or[(6.8±1.5)IgCFU/g,P<0.05]in AFL group,or[(7.1±11.3)IgCFU/g,P<0.05]in healthy control group;the number of Enterococcus faecalis in ALC group was(9.52.3)IgCFU/g,significantly higher than[(7.1±1.3)IgCFU/g,P<0.05]in patients with AFL,or[(6.5±1.5)IgCFU/g,P<0.05]in healthy control group,or[(8.6±1.5)IgCFU/g,P<0.05]in AH group;the number of Bifidobalcterium in ALC group was(6.30.7)IgCFU/g,much lower than[(7.2±1.1)IgCFU/g,P<0.05]in AH group,or[(

关 键 词：酒精性肝病 脂肪酶 过氧化脂质 一氧化氮合成酶 肠道菌群 

分 类 号：R575.5[医药卫生—消化系统]