双歧杆菌四联活菌片对乙肝相关慢加急性肝衰竭合并感染患者肠道菌群及免疫功能的影响  

Effect of Bifidobacterium Tetravaccine Tablets on intestinal microecology and immune function in patients with secondary infections to HBV-related acute-on-chronic liver failure

作　　者：王春[1] 叶云 WANG Chun;YE Yun(Department of Gastroenterology,the Sixth People′s Hospital of Neijiang,Neijiang,Sichuan 641000,China;不详)

机构地区：[1]内江市第六人民医院消化内科,四川641000 [2]内江市第一人民医院全科医疗科

出　　处：《中国微生态学杂志》2021年第8期944-948,共5页Chinese Journal of Microecology

摘　　要：目的分析双歧杆菌四联活菌片对乙肝相关慢加急性肝衰竭(HBV-ACLF)合并感染患者肠道菌群及免疫功能的影响,为该病的治疗提供参考。方法选择2017年12月至2018年12月我院收治的106例HBV-ACLF合并感染患者,采用随机数字表法将其分为对照组(n=53)与研究组(n=53)。对照组患者采用常规治疗,研究组患者在对照组基础上口服双歧杆菌四联活菌片,两组患者均治疗1个月。比较两组患者治疗总有效率及肠道菌群(双歧杆菌、肠球菌、乳杆菌、肠杆菌)、免疫功能(CD4^(+)细胞、CD8^(+)细胞、CD4^(+)/CD8^(+))、肝功能[丙氨酸氨基转移酶(ALT)、天冬氨酸转氨酶(AST)]情况。结果研究组患者治疗总有效率显著高于对照组(90.57%vs 73.58%,χ^(2)=5.194,P=0.023)。治疗前,两组患者肠道双歧杆菌、肠球菌、乳杆菌、肠杆菌数量及CD4^(+)细胞、CD8^(+)细胞、CD4^(+)/CD8^(+)、AST、ALT水平差异无统计学意义(均P>0.05)。治疗后,对照组患者肠道双歧杆菌、肠球菌、乳杆菌、肠杆菌数量较治疗前差异无统计学意义(均P>0.05),而研究组患者肠道乳杆菌、双歧杆菌数量较治疗前显著升高,肠杆菌、肠球菌数量较治疗前显著下降(均P<0.05)。治疗后两组患者CD4^(+)细胞、CD4^(+)/CD8^(+)水平较治疗前显著升高,CD8^(+)细胞、AST、ALT水平较治疗前显著下降(均P<0.05)。治疗后研究组患者CD4^(+)细胞、CD4^(+)/CD8^(+)水平较对照组显著升高,CD8^(+)细胞、AST、ALT水平较对照组显著下降(均P<0.05)。结论双歧杆菌四联活菌片治疗HBV-ACLF合并感染患者的临床疗效较好,能够调节患者肠道菌群,改善患者免疫功能及肝功能,值得临床推广。Objective To observe the effect of Bifidobacterium Tetravaccine Tablets(BTTs) on intestinal flora and immune function in patients with secondary infections to hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF), and provide a reference for treatment. Methods A total of 106 patients with secondary infections to HBV-ACLF in our hospital from December 2017 to December 2018 were enrolled, and randomly divided into two groups, with 53 cases in each group. The control group received conventional treatment, while the observation group received conventional treatment combined with BTTs. All patients were treated for 1 month. The clinical efficacy, intestinal flora(Bifidobacterium, Enterococcus, Lactobacillus, Enterobacter), immune function(CD4^(+) cell, CD8^(+) cell, CD4^(+)/CD8^(+)), and liver function indexes [alanine aminotransferase(ALT), asthenate transaminase(AST)] were compared between the two groups. Results The total clinical efficacy in the observation group was significantly higher than that in the control group(90.57% vs 73.58%, χ^(2)=5.194, P=0.023). Before treatment, there was no significant difference in the number of intestinal Bifidobacterium, Enterococcus, Lactobacillus, Enterobacter and the levels of CD4^(+) cell, CD8^(+)cell, CD4^(+)/CD8^(+), AST and ALT between the two groups(all P>0.05). After treatment, there was no statistically significant difference in intestinal Bifidobacterium, Enterococcus, Lactobacillus, and Enterobacter in the control group compared with before treatment(all P>0.05). In observation group, intestinal Lactobacillus and Bifidobacterium were increased, while Enterococcus and Enterobacter were decreased after treatment(all P<0.05). After treatment, blood CD4^(+) cell and CD4^(+)/CD8^(+) levels were increased in both groups compared with before treatment(all P<0.05), and the levels of CD8^(+) cells, AST, and ALT were significantly decreased(all P<0.05). After treatment, the levels of CD4^(+) cells and CD4^(+)/CD8^(+) in observation group were significantly higher

关 键 词：双歧杆菌四联活菌片 乙肝相关慢加急性肝衰竭 继发感染 临床疗效 肠道微生态 免疫功能 肝功能 

分 类 号：R446.5[医药卫生—诊断学]