基于真实世界数据的微生态制剂增强慢性乙型肝炎肝硬化患者疗效与免疫功能的作用分析  

Role of probiotics in enhancing the efficacy and immune function of patients with chronic hepatitis B and cirrhosis based on real-world data

作　　者：刘青青[1] 卞理[1] LIU Qingqing;BIAN Li(Pharmacy Department of the Third Affiliated Hospital of Nantong University,Nantong,Jiangsu 226006,China;不详)

机构地区：[1]南通大学附属南通第三医院药学部,江苏南通226006

出　　处：《中国微生态学杂志》2024年第9期1066-1072,共7页Chinese Journal of Microecology

摘　　要：目的基于真实世界数据探讨微生态制剂对慢性乙型肝炎肝硬化患者疗效及免疫功能的影响。方法对南通市2022年5月至10月三甲综合医院信息系统(HIS)1068例慢性乙型肝炎肝硬化患者的报告进行调查分析,根据是否使用微生态制剂分为A组(n=796,使用微生态制剂)、B组(n=272,不使用微生态制剂)。进一步根据微生态制剂类别将A组分为A1、A2、A3、A4组。比较各组中不同微生态制剂的疗效,治疗前后患者肝功能,治疗前后患者细胞免疫功能和并发症情况。结果A组患者治疗3个月和6个月的总有效率均高于B组(84.93%vs 61.14%,92.63%vs 64.95%;均P<0.05)。治疗后A组患者血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)水平均低于本组治疗前与B组治疗后(均P<0.05)。治疗后A组患者CD4^(+)细胞、自然杀伤(NK)细胞、CD4^(+)/CD8^(+)水平均高于本组治疗前与B组治疗后,CD8^(+)细胞水平均低于本组治疗前与B组治疗后(均P<0.05)。A组患者并发症发生率低于B组(P<0.05)。A1、A2、A3组患者治疗3个月和6个月的总有效率均高于A4组(86.89%、85.29%、89.23%vs 66.00%,95.53%、92.11%、97.22%vs 71.88%;均P<0.05)。A1、A2、A3、A4组患者治疗后血清ALT、AST、TBIL水平均低于同组治疗前,且治疗后A1、A2、A3组患者血清ALT、AST、TBIL水平均低于A4组(均P<0.05)。A1、A2、A3、A4组患者治疗后CD4^(+)细胞、NK细胞、CD4^(+)/CD8^(+)水平均高于治疗前、CD8^(+)细胞水平均低于治疗前,且治疗后A1、A2、A3组患者CD4^(+)细胞、NK细胞、CD4^(+)/CD8^(+)水平均高于A4组,CD8^(+)细胞水平均低于A4组(均P<0.05)。A1、A2、A3组患者并发症发生率均低于A4组(均P<0.05)。结论微生态制剂可增强慢性乙型肝炎肝硬化患者的疗效、肝功能及细胞免疫功能,还可减少并发症,且双歧杆菌三联活菌、双歧杆菌乳杆菌三联活菌、双歧杆菌四联活菌作用更佳。Objective To explore the effects of probiotics on the efficacy and immune function of patients with chronic hepatitis B(CHB)and cirrhosis based on real-world data.Methods The reports on 1,068 cases of CHB and cirrhosis from the third class general hospital information system(HIS)from May to December 2022 in Nantong city were investigated and analyzed,which were divided into Group A(n=796,probiotics used)and Group B(n=272,probiotics not used)based on whether probiotics were used.The Group A was further divided into groups A1,A2,A3 and A4 according to the category of microecological agents.The efficacy,liver function and cellular immune function before and after treatment and complications were compared among the groups.Results After 3 months and 6 months of treatment,the total efficiency rates in group A were higher than those in group B(84.93%vs 61.14%,92.63%vs 64.95%,all P<0.05).After treatment,the serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBIL)in group A were lower than before treatment and those in group B after treatment(all P<0.05).The levels of CD4^(+)cell,CD4^(+)/CD8^(+)and natural killer(NK)cell in group A were higher,while that of CD8^(+)cell was lower than those before treatment and those in group B after treatment,respectively(all P<0.05).The incidence of complications in group A was lower than that in group B(P<0.05).After 3 months and 6 months of treatment,the total efficiency rates in the groups A1,A2 and A3 were higher than those in the group A4(86.89%,85.29%,89.23%vs 66.00%;95.53%,92.11%,97.22%vs 71.88%;all P<0.05).After treatment,ALT,AST and TBIL in the groups A1,A2,A3 and A4 were lower than those before treatment(all P<0.05),and those in groups A1,A2 and A3 groups were lower than that in group A4(all P<0.05).CD4^(+)cell,CD4^(+)/CD8^(+)and NK cell in groups A1,A2,A3 and A4 after treatment were higher,while CD8^(+)cell was lower than those before treatment,respectively(all P<0.05).CD4^(+)cell,CD4^(+)/CD8^(+)and NK cell in groups A1,A2 and A3

关 键 词：微生态制剂 慢性乙型肝炎 肝硬化 免疫功能 

分 类 号：R657.31[医药卫生—外科学]