基于肠道分子微生态系统平衡防治肝硬化自发性腹膜炎的研究  

Prevention and treatment of liver cirrhosis spontaneous peritonitis based on intestinal molecular microecosystem balance

作　　者：杨晓薇[1] 伍沁芳 汤金萍[1] 李翠红[1] 喻枝红 龚锦文 YANG Xiaowei;WU Qinfang;TANG Jinping;LI Cuihong;YU Zhihong;GONG Jinwen(Department of Gastroenterology,Jiujiang First People′s Hospital,Jiujiang,Jiangxi 332000,China)

机构地区：[1]九江市第一人民医院消化内科,江西九江332000

出　　处：《检验医学与临床》2022年第23期3199-3201,3205,共4页Laboratory Medicine and Clinic

基　　金：江西省卫生健康委员会科技计划项目(202140281)。

摘　　要：目的探讨基于肠道分子微生态系统平衡治疗肝硬化自发性腹膜炎(SBP)的效果。方法选择2020年6月至2021年5月于该院治疗的40例肝硬化并发SBP患者作为研究对象,根据治疗方法将其分为观察组和对照组,各20例。对照组采用常规抗菌药物治疗,观察组于对照组基础上采用双歧杆菌三联活菌胶囊调节肠道分子微生态,两组均连续治疗2周。比较两组肠道菌群、细胞因子、内毒素(ET)、肠道分泌型免疫球蛋白(SIgA)、肝纤维化指标、治愈率及不良反应发生情况。结果治疗后观察组肠球菌属、肠杆菌属菌群数量低于对照组,双歧杆菌属、拟杆菌属、梭菌属、乳酸菌属菌群数量高于对照组,差异均有统计学意义(P<0.05);治疗后观察组肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及ET水平低于对照组,SIgA水平高于对照组,层粘连蛋白(LN)、透明质酸(HA)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原(PC-Ⅲ)水平低于对照组,差异均有统计学意义(P<0.05);观察组治愈率高于对照组,差异有统计学意义(P<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论采用双歧杆菌三联活菌胶囊,有利于调节肝硬化并发SBP患者的肠道微生态,降低炎症因子水平,改善肝脏纤维化,减少ET产生,保护患者肠道功能,安全可靠。Objective To investigate the therapeutic effect of spontaneous peritonitis(SBP)in liver cirrhosis based on intestinal molecular microecosystem balance.Methods Forty patients with cirrhosis complicated with SBP treated in our hospital from June 2020 to May 2021 were selected as the research objects.According to the treatment methods,they were divided into the observation group and the control group,with 20 cases in each group.The control group was treated with conventional antibiotics,and the observation group was treated with Bifidobacterium triple viable capsule on the basis of the control group to regulate intestinal molecular microecology.Both groups were treated for 2 weeks.The intestinal microbiota,cytokines,endotoxin(ET),intestinal secretory immunoglobulin(SIgA),liver fibrosis indexes,cure rate and adverse reactions were compared between the two groups.Results After treatment,the number of Enterococcus and Enterobacter in the observation group were lower than those in the control group,and the number of Bifidobacterium,Bacteroides,Clostridium and Lactobacillus in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and ET in the observation group were lower than those in the control group,SIgA level was higher than that in the control group,the levels of laminin(LN),hyaluronic acid(HA),typeⅣcollagen(Ⅳ-C)and typeⅢprocollagen(PC-Ⅲ)were lower than those in the control group,and the differences were statistically significant(P<0.05).The cure rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Bifidobacterium triple viable capsule is beneficial to regulate the intestinal flora dysregulation in patients with cirrhosis complicated with SBP,reduce the level of

关 键 词：肝硬化 自发性腹膜炎 双歧杆菌三联活菌 肠道微生态 肠道菌群 

分 类 号：R575.2[医药卫生—消化系统] R572.2[医药卫生—内科学]