双歧杆菌三联活菌对老年腹膜透析患者血清微炎症、营养状况指标及终点事件的影响  

Effects of Bifidobacterium triple viable bacteria on serum micro-inflammation,nutritional status and endpoint events in elderly peritoneal dialysis patients

作　　者：刘翠兰[1] 郭宝珠 金玉杰 韩小丽 刘圣君[1] 刘俊芬[1] 潘星[1] Liu Cuilan;Guo Baozhu;Jin Yujie;Han Xiaoli;Liu Shengjun;Liu junfen;Pan Xing(Department of Nephrology,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院肾内科,张家口075000

出　　处：《中华老年医学杂志》2023年第6期650-655,共6页Chinese Journal of Geriatrics

基　　金：河北省医学科学研究课题计划(20200542)。

摘　　要：目的观察老年腹膜透析患者经双歧杆菌三联活菌治疗后血清微炎症及营养状况指标的变化以及对终点事件的影响。方法将180例老年腹膜透析患者分为对照组和观察组各90例。两组均在常规干预措施下实施腹膜透析,观察组在此基础上口服双歧杆菌三联活菌,疗程均为12个月。分别于治疗前、治疗6个月及12个月后,采集患者清晨空腹静脉血,采用酶联免疫吸附(ELISA)法检测血清微炎症指标[肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、白细胞介素-8(IL-8)、C反应蛋白(CRP)]水平,全自动血液生化分析仪检测血清营养状况指标及透析充分性指标[营养状况指标:白蛋白(ALB)、血红蛋白(Hb)、转铁蛋白(TRF)、前白蛋白(PA)、钙离子、磷离子;透析充分性指标:血肌酐(Scr)、血尿酸(BUA)、尿素氮(BUN)、半胱氨酸蛋白酶抑制剂C(Cys-c)]水平;随访24个月,记录两组终点事件(腹膜炎、腹痛、营养不良、腹腔感染、心脑血管意外)的发生情况。结果治疗24个月后,两组TNF-α、IL-6、IL-8、CRP水平均较治疗前下降,且观察组低于对照组[(25.7±4.0)μg/L比(33.6±6.0)μg/L、(2.9±0.7)ng/L比(4.9±1.2)ng/L、(17.0±7.2)ng/L比(22.8±7.9)ng/L、(4.6±0.7)mg/L比(6.9±1.2)mg/L](t=10.272、13.134、5.040、15.575,均P<0.05);治疗24个月后,两组ALB、Hb、TRF、PA、钙离子水平均较治疗前升高,磷离子较治疗前下降,且上述指标观察组升降大于对照组[(45.7±5.2)g/L比(39.8±4.9)g/L、(72.7±8.0)g/L比(68.6±9.0)g/L、(4.3±1.0)g/L比(3.0±0.6)g/L、(321.5±29.0)mg/L比(297.6±25.1)mg/L、(4.9±1.3)mmol/L比(2.9±0.9)mmol/L、(1.3±0.9)mmol/L比(1.8±0.3)mmol/L](t=7.737、3.213、9.880、5.900、11.937、4.415,均P<0.05);两组治疗前肠道菌群指标比较差异无统计学意义(均P>0.05);24个月后,两组乳酸杆菌、双歧杆菌均上升,肠杆菌、肠球菌均下降,且上述指标观察组升降大于对照组[(8.4±0.9)IgCFU/g比(6.4±0.9)IgCFU/g、(8.8±1.3)IgObjective To observe the changes of serum micro-inflammatory and nutritional status in elderly peritoneal dialysis patients after treatment with bifidobacterium triple viable bacteria,and the impact of Bifidobacterium triple viable bacteria treatment on the endpoint.Methods Totally 180 elderly patients receiving peritoneal dialysis were divided into control group and observation group,with 90 cases in each.Both groups were treated on the basis of the routine treatment,the observation group was treated with oral Bifidobacterium triple viable bacteria for twelve months.Before treatment,6 months and 12 months after treatment,fasting venous blood from the patients in the two groups were collected in the morning.The levels of serum micro-inflammatory indexes[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8),C-reactive protein(CRP)]were detected by ELISA.The nutritional status and dialysis adequacy indexes[nutritional status:albumin(ALB),hemoglobin(Hb),transferrin(TRF),prealbumin(PA),calcium ion,phosphorus ion;indicators of dialysis adequacy:serum creatinine(Scr),blood uric acid(BUA),blood urea nitrogen(BUN),cystatin C(Cys-c)levels]were detected by automatic blood biochemical analyzer.After 24 months of follow-up,the occurrence of endpoint events(peritonitis,abdominal pain,malnutrition,abdominal infection,cardiovascular and cerebrovascular accidents)in the two groups was recorded.Results After 24 months of treatment,the levels of TNF-α,IL-6,IL-8 and CRP in the two groups were lower than those before treatment,and the observation group was lower than control group[(25.7±4.0)μg/L vs.(33.6±6.0)μg/L,(2.9±0.7)ng/L vs.(4.9±1.2)ng/L,(17.0±7.2)ng/L vs.(22.8±7.9)ng/L,(4.6±0.7)mg/L vs.(6.9±1.2)mg/L](t=10.272,13.134,5.040,15.575,respectively,P<0.05 for all).After 24 months of treatment,the levels of ALB,Hb,TRF,PA and calcium ion of the two groups were higher than before treatment,and the levels of phosphorus ion were lower than before treatment,and the changes of the above indicators in observati

关 键 词：腹膜透析 双歧杆菌三联活菌 炎症 营养状况 终点事件 

分 类 号：R459.5[医药卫生—治疗学]