布拉酵母菌辅助治疗对老年CagA和VacA阳性幽门螺杆菌感染患者IL-6和IL-8及肠道菌群的影响  

The effect of Saccharomyces boulardii assisted eradication of CagA and VacA positive Helicobacter pylori on IL-6,IL-8 and intestinal flora in elderly patients

作　　者：何晨熙 孔凡庭[1] 朱新影[2] 王魁向 孔凡磊[1] 周培培 刘艳玲 赵巍 赵东强[3] HE Chen-xi;KONG Fan-ting;ZHU Xin-ying;WANG Kui-xiang;KONG Fan-lei;ZHOU Pei-pei;LIU Yan-ling;ZHAO Wei;ZHAO Dong-qiang(Department of Gastroenterology,Xingtai People’s Hospital,Xingtai,Hebei 054000,China;不详)

机构地区：[1]邢台市人民医院,河北054000 [2]河北医科大学第三医院消化内科 [3]河北医科大学第二医院消化内科

出　　处：《中国微生态学杂志》2022年第10期1191-1196,共6页Chinese Journal of Microecology

基　　金：河北省卫健委青年科技基金项目(20210237)。

摘　　要：目的评价布拉酵母菌(S.boulardii)对老年细胞毒素相关蛋白A(cytotoxin-associated gene A protein,CagA)和空泡毒素(vacuolating cytotoxin A,VacA)阳性幽门螺杆菌(H.pylori)感染患者炎症因子及肠道菌群的影响,以探讨S.boulardii治疗H.pylori I型高毒力株感染的机制。方法选择我院200例CagA和VacA阳性的老年H.pylori感染者,采用随机数字表分成四联组和S.boulardii组。四联组患者采用铋剂四联疗法,S.boulardii组在铋剂四联疗法基础上加用S.boulardii。比较两组患者H.pylori根除率、胃黏膜组织学评分、临床疗效评分、不良反应、血清白细胞介素(IL)-6及IL-8水平、肠道菌群分布。结果(1)S.boulardii组H.pylori根除率按方案(PP)分析和按意向性(ITT)分析均高于四联组(85.1%vs 72.8%;80.0%vs 67.0%),差异均有统计学意义(均P<0.05)。(2)S.boulardii组患者不良反应发生率(7.0%)低于四联组(21.0%),差异有统计学意义(χ^(2)=8.140,P=0.004)。(3)治疗后,两组患者胃黏膜组织学评分、临床症状评分、血清IL-6及IL-8水平均较治疗前降低,且S.boulardii组低于四联组(均P<0.05)。(4)治疗后,四联组患者肠道乳杆菌、双歧杆菌数量较治疗前减少,肠杆菌、肠球菌数量较治疗前增加(均P<0.05);而S.boulardii组患者肠道乳杆菌、双歧杆菌数量较治疗前增加(均P<0.05),肠杆菌、肠球菌数量较治疗前差异无统计学意义(均P>0.05)。结论S.boulardii辅助四联疗法可提高老年患者H.pylori I型高毒力株的根除效果,减轻患者胃黏膜组织炎症,降低不良反应,其机制可能与S.boulardii下调免疫炎症介质表达和改善肠道菌群分布有关。Objective To evaluate the effect of Saccharomyces boulardii(S.boulardii)assisted eradication of Cytotoxinassociated gene A protein(CagA)and Vacuolating cytotoxin A(VacA)positive Helicobacter pylori(H.pylori)on inflammatory factors and intestinal flora in elderly patients and explore the mechanism of S.boulardii in treating H.pylori typeⅠhypervirulent strain infection.Methods Two hundredelderly patients with CagA and VacA positive H.pylori infection were selected and randomly divided into quadruple therapy group or S.boulardii group.Both groupswere treated with bismuth quadruple therapy,and S.boulardii group was additionally treated with S.boulardii.The eradication rate of H.pylori,gastric mucosal histological score,clinical efficacy score,adverse reactions,serum levels of interleukin 6 and IL-8,and intestinal flora distribution were compared between the two groups.Results(1)The eradication rates of H.pylori in S.boulardii group by Per-protocol(PP)analysis and by intention-to-treat(ITT)analysis were higher than in the quadruplet therapy group respectively(85.1%vs 72.8%,80.0%vs 67.0%),with statistically significant difference(all P<0.05).(2)The adverse reaction rate in S.boulardii group(7.0%)was lower than in the quadruplet therapy group(21.0%),with statistically significant difference(χ^(2)=8.140,P=0.004).(3)After treatment,the gastric mucosal histological score,clinical symptom score,and serum levels of IL-6 and IL-8 in both groups were lower than those before treatment,with those in the S.boulardii group than in the quadruplet therapy group(all P<0.05).(4)After treatment,the counts of Lactobacillus and Bifidobacterium in the intestinal tract in the quadruple therapy group decreased compared with those before treatment,while the counts of Enterobacterium and Enterococcus increased(all P<0.05).After treatment,the counts of Lactobacillus and Bifidobacterium in the intestinal tract in S.boulardii group increased compared with those before treatment(all P<0.05),while the counts of Enterobacterium and Enterococcus

关 键 词：幽门螺杆菌 细胞毒素相关蛋白A 空泡毒素 肠道菌群 布拉酵母菌 

分 类 号：R573.9[医药卫生—消化系统]