双歧杆菌制剂对终末期肾病患者肠道菌群和微炎症状态的影响  

Effect of bifidobacteria preparation on intestinal flora and microinflammatory status in patients with end-stage renal disease

作　　者：张颜 张文 张燕芳 周静 ZHANG Yan;ZHANG Wen;ZHANG Yanfang;ZHOU Jing(Department of Nephrology, The Third People's Hospital of Yunnan Province, Kunming 650118, China;Department of Gastroenterology, The Third People's Hospital of Yunnan Province, Kunming 650118, China)

机构地区：[1]云南省第三人民医院1.肾病科 [2]消化内科,云南昆明650118

出　　处：《西部医学》2022年第7期1011-1015,1020,共6页Medical Journal of West China

基　　金：云南省教育厅科学研究项目(2021J0344)。

摘　　要：目的 探讨双歧杆菌乳杆菌三联活菌片对终末期肾病(ESRD)患者微炎症状态和肠道菌群的作用。方法 选取2019年2月~2021年2月我院收治的180例ESRD患者作为研究对象,根据就诊顺序奇偶数将奇数者纳入观察组,偶数者纳入对照组,每组90例。对照组给予常规治疗和血液透析,观察组在此基础上给予口服双歧杆菌乳杆菌三联活菌片。比较两组治疗前后血浆生化指标[血尿素氮(BUN)、血肌酐(SCr)、β2微球蛋白(β2-MG)、尿酸、甲状旁腺激素(PTH)、血胱抑素C(Cys-C)]和炎症因子[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)]水平,以及粪便菌群丰富度、多样性和组成差异。结果 观察组和对照组分别有3例和5例失访,最终分别纳入87例和85例;治疗后,观察组血浆BUN、SCr、β2-MG、尿酸、PTH、Cys-C水平与对照组比较,差异均无统计学意义(P>0.05);治疗后,观察组IL-6和TNF-α水平低于对照组,IL-10水平高于对照组(均P<0.05);治疗后,观察组Chao1、ACE、Shannon、Simpson指数均高于对照组(P<0.05);观察组治疗前肠道菌群中拟杆菌属(Bacteroides)、链球菌属(Streptococcus)、瘤胃球菌科(Ruminococcaceae)、厌氧菌属(Anaerotruncus)、梭杆菌门(Fusobacteria)为主要优势,而治疗后观察组以双歧杆菌属(Bifidobacterium)、普氏菌科(Prevotellaceae)、乳酸杆菌属(Lactobacillus)、粪杆菌属(Feacalibacterium)、副拟杆菌属(Parabacteroides)为主要优势。结论 双歧杆菌乳杆菌三联活菌片可改善ESRD患者肠道菌群丰度和多样性,减轻患者的微炎症状态。Objective To explore the effect of Live Combined Bifidobacterium and Lactobacillus Tablets on the microinflammatory state and intestinal microflora in end-stage renal disease(ESRD)patients.Methods 180 ESRD patients treated in our hospital from February 2019 to February 2021 were employed as research subjects,the odd-numbered individuals were included in the experimental group(90 cases)and the even-numbered individuals in the control group(90 cases)according to the odd-even order of visit.Patients in control group was treated with routine treatment and hemodialysis,in the experimental group,Live Combined Bifidobacterium and Lactobacillus Tablets were added based on this.Plasma biochemical indicators and inflammatory factors in pre and post treatment of two groups,as well as richness,diversity and composition of fecal flora were comparatively analyzed.Results 3 cases and 5 cases were respectively lost to follow up in the experimental group and control group,finally 87 cases and 85 cases were in included respectively;After treatment,there were not statistical difference between experimental group and control group in blood urea nitrogen(BUN),serum creatinine(SCr),β2-microglobulin(β2-MG),uric acid,parathyroid hormone,cystatin C(Cys-C)(P>0.05);However,the interleukin(IL-6) and tumor necrosis factor(TNF)-αin the experimental group were lower than those in the control group,IL-10 in the experimental group was higher than that in the control group(all P<0.05);After treatment,Chao1,ACE,Shannon and Simpson index in the experimental group were higher than those in the control group(P<0.05);Bacteroides,Streptococcus,Ruminococcaceae,Anaerotruncus,Fusobacteria were predominant in the intestinal flora before treatment in both groups,Bifidobacterium,Prevotellaceae,Lactobacillus,Feacalibacterium,Parabacteroides were predominant in the intestinal flora after treatment in the experimental group.Conclusion Live Combined Bifidobacterium and Lactobacillus Tablets improve the abundance and diversity of intestinal flora in ESRD patie

关 键 词：双歧杆菌 终末期肾病 肠道菌群 微炎症状态 

分 类 号：R692.5[医药卫生—泌尿科学]