枯草杆菌二联活菌对儿童巨细胞病毒性肝炎患儿肠道菌群及预后的影响  

Effect of double viable Bacillus subtilis on intestinal flora and prognosis in children with cytomegalovirus hepatitis

作　　者：陈丹丹 尹杨艳 桂冬梅 CHEN Dan-dan;YIN Yang-yan;GUI Dong-mei(The First Affiliated Hospital of Hainan Medical University,Haikou,Hainan 570100,China;不详)

机构地区：[1]海南医学院第一附属医院儿科,海南海口570100

出　　处：《中国微生态学杂志》2022年第1期82-85,共4页Chinese Journal of Microecology

摘　　要：目的探究枯草杆菌二联活菌对儿童巨细胞病毒(CMV)性肝炎患儿肠道菌群的调节作用及其对预后的影响。方法选择2016年5月到2019年5月我院收治的81例重症巨细胞病毒性肝炎患儿为研究对象,按照随机数字表法分为联合组(n=41)和对照组(n=40)。对照组患儿采用常规治疗方法,联合组患儿在对照组基础上联合枯草杆菌二联活菌颗粒治疗。比较两组患儿肝功能[谷丙转氨酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)]、肠道菌群(双歧杆菌属、乳杆菌属、芽胞杆菌属、肠球菌属、肠杆菌属、拟杆菌属)、CMV-DNA、CMV-IgM转阴率及预后。结果治疗后联合组患儿肠道芽胞杆菌属、肠球菌属数量高于对照组,肠杆菌属数量低于对照组,差异均有统计学意义(均P<0.05)。治疗后联合组患儿血清ALT、AST、TBIL水平低于对照组,CMV-DNA、CMV-IgM转阴率均高于对照组,差异均有统计学意义(均P<0.05)。随访3个月,联合组患儿治愈率、好转率均高于对照组,差异有统计学意义(均P<0.05)。两组患儿病死率差异无统计学意义(0.00%vs 2.50%,χ^(2)=1.012,P=0.314)。结论枯草杆菌二联活菌联合常规治疗可有效促进巨细胞病毒性肝炎患儿肠道菌群平衡,提高患儿肝功能和病毒清除率,从而改善预后。Objective To observe the effect of double viable Bacillus subtilis on intestinal flora and prognosis in children with cytomegalovirus(CMV)hepatitis.Methods A total of 81 children with severe CMV hepatitis admitted to our hospital from May 2016 to May 2019 were enrolled and divided into the combination group(n=41)or control group(n=40)randomly.Both groups were given conventional treatment,while the combination group was additionally given double viable Bacillus subtilis.The liver function indexes(ALT,AST,TBIL),intestinal flora(Bifidobacterium,Lactobacillus,Bacillus,Enterococcus,Enterobacterium,Bacteroides),CMV-DNA,CMV-IgM negative rate and prognosis were compared between groups.Results After treatment,the counts of intestinal Bacillus and Enterococcus in the combination group were higher,while that of Enterobacterium was lower than in the control group,respectively(all P<0.05).After treatment,the levels of serum ALT,AST and TBIL were lower and the conversion rates of CMV-DNA and CMV-IgM were higher in the combination group than those in the control group respectively(all P<0.05).After 3 months of follow-up,the cure rate and improvement rate in the combination group were higher than those in the control group respectively(all P<0.05),but there was no significant difference in mortality between the two groups(0.00%vs 2.50%,χ^(2)=1.012,P=0.314).Conclusion The double viable Bacillus subtilis combined with conventional treatment in cytomegalovirus hepatitis can improve the liver function and virus clearance rate by promoting the balance of intestinal flora,thereby improve the prognosis.

关 键 词：枯草杆菌二联活菌 巨细胞病毒性肝炎 肠道菌群 疾病转归 

分 类 号：R72[医药卫生—儿科]