双歧四联活菌辅助替诺福韦对老年乙肝肝硬化患者肝纤维化程度、血清sICAM-1、TLR-4水平的影响  

Effects of bifidobacteria combined with tenofovir on liver fibrosis,serum sICAM-1 and TLR-4 levels in elderly patients with hepatitis B cirrhosis

作　　者：梁昊 钱鹏[2] 闫斌斌[3] Liang Hao;Qian Peng;Yan Bin-bin(Department of Gastroenterology,Yucheng People's Hospital,Shangqiu 476300,Henan,China;Department of Geriatrics,Henan Provincial People's Hospital,Zhengzhou 450000,China;Department of Gastroenterology,Henan Provincial People'sHospital,Zhengzhou 450000,China)

机构地区：[1]虞城县人民医院消化内科,河南商丘476300 [2]河南省人民医院老年医学科,河南郑州450000 [3]河南省人民医院消化内科,河南郑州450000

出　　处：《四川生理科学杂志》2023年第3期426-429,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:探讨双歧四联活菌辅助替诺福韦对老年乙肝肝硬化(Hepatitis B cirrhosis,HBC)患者肝纤维化程度、炎性免疫相关因子水平的影响。方法:选取2020年1月~2021年12月本院收治的83例老年HBC患者作为研究对象,按照随机数字表法分为对照组(n=41)和观察组(n=42)。对照组口服替诺福韦治疗,观察组在对照组基础上增加口服双歧四联活菌治疗。对比分析两组患者临床疗效及治疗前后肠道菌群数量、肝功能指标、肝纤维化指标、炎性免疫相关因子水平。结果:观察组总有效率明显高于对照组(P<0.05);治疗后,观察组双歧杆菌、乳酸杆菌较对照组增多,肠杆菌、肠球菌较对照组减少(P<0.05);观察组丙氨酸氨基转移酶(Alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(Aspartate aminotransferase,AST)、总胆红素(Total bilirubin,TBIL)、透明质酸(Hyaluronic acid,HA)、Ⅳ型胶原(Collagen type IV,C-Ⅳ)、层粘连蛋白(Laminin,LN)、可溶性细胞间黏附分子-1(Soluble intercellular adhesion molecule-1,sICAM-1)、Tol样受体4(Tol-like receptor 4,TLR-4)水平明显低于对照组,白蛋白(Albumin,ALB)水平明显高于对照组(P<0.05)。结论:老年HBC患者应用双歧四联活菌辅助替诺福韦治疗效果确切,可调节肠道菌群,改善其肝功能,抑制肝纤维化进程,其作用机制可能与降低血清sICAM-1、TLR-4水平有关。Objective:To investigate the effect of bifidobacteria combined with tenofovir on the degree of liver fibrosis and the level of inflammatory immune related factors in elderly patients with hepatitis B B cirrhosis(HBC).Methods:A total of 83 elderly HBC patients admitted to our hospital from January 2020 to December 2021 were selected as research objects,and randomly divided into control group(n=41)and observation group(n=42).The control group was treated with tenofovir,and the observation group was treated with bifidobacteria on the basis of the control group.Comparative analysis of the clinical efficacy of the two groups and the number of intestinal flora,liver function indicators,levels of liver fibrosis indicators,inflammatory immune related factors.Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,bifidobacteria and lactobacilli in the observation group increased compared with the control group,and enterobacteria and enterococcus decreased compared with the control group(P<0.05).After treatment,the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),hyaluronic acid(HA),collagen type IV(C-IV),laminin(LN),soluble intercellular adhesion molecule-1(sICAM-1)and Tol like receptor 4(TLR-4)in the observation group were lower than those in the control group,and the levels of albumin(ALB)were higher than those in the control group(P<0.05).Conclusion:Bifidobacterium combined with tenofovir is effective in elderly patients with HBC.It can regulate intestinal flora,improve liver function,and inhibit the process of liver fibrosis.Its mechanism may be related to the reduction of serum sICAM-1 and TLR-4 levels.

关 键 词：乙肝肝硬化 双歧四联活菌 替诺福韦 肝纤维化 可溶性细胞间黏附分子-1 

分 类 号：R575.2[医药卫生—消化系统]