美罗培南联合益生菌对肝硬化并发自发性细菌性腹膜炎患者的疗效  

Effect of meropenem combined with probiotics in the treatment of patients with cirrhosis complicated with spontaneous bacterial peritonitis

作　　者：王欢欢[1] 顾而立[1] WANG Huanhuan;GU Erli(Department of Gastroenterology,Jingan District Central Hospital of Shanghai,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属静安区中心医院消化内科,上海200040

出　　处：《世界临床药物》2024年第9期931-936,共6页World Clinical Drug

基　　金：上海市医学重点专科建设项目(ZK2019B24)。

摘　　要：目的 探究美罗培南联合益生菌对肝硬化并发自发性细菌性腹膜炎(spontaneous bacterial peritonitis,SBP)患者炎性反应及肠黏膜屏障功能的影响。方法 选取2021年1月至2023年3月在静安区中心医院治疗的102例肝硬化并发SBP患者为研究对象,分为对照组(美罗培南治疗)52例,研究组(美罗培南与双歧杆菌三联活菌肠溶胶囊联合治疗)50例。比较两组疗效、治疗前后炎症因子水平、肠黏膜屏障功能以及不良反应发生情况。结果 研究组总有效率(94.00%)显著高于对照组(78.85%)(P<0.05)。治疗后,两组患者炎症因子水平、二胺氧化酶、D-乳酸水平及尿乳果糖排泄率与甘露醇排泄率比值均下降(P<0.05),且研究组较对照组下降更显著(P<0.05)。两组不良反应发生率无显著性差异(P>0.05)。结论 益生菌联合美罗培南治疗可有效提高肝硬化并发SBP的临床疗效,抑制炎症因子分泌,改善患者肠黏膜屏障功能,且安全性较高。Objective To explore the effects of meropenem combined with probiotics on inflammatory response and intestinal mucosal barrier function in patients with spontaneous bacterial peritonitis(SBP)caused by liver cirrhosis.Methods A total of 102 patients with cirrhosis complicated with SBP who were treated in Jing-an district central hospital from January 2021 to March 2023 were selected as the study objects,and were divided into 52 cases in the control group(meropenem treatment)and 50 cases in the study group(meropenem combined with bifidobacterium triactive enteric capsule treatment).The curative effect,inflammatory factor levels,intestinal mucosal barrier function,and adverse reactions before and after the treatment were compared between the two groups.Results The total effective rate of the study group(94.00%)was significantly higher than that of the control group(78.85%)(P<0.05).After treatment,the levels of inflammatory factors,diamine oxidase,D-lactic acid and the ratio of urinary lactulose excretion rate to mannitol excretion rate were decreased in two groups(P<0.05),and the decrease was more significant in the study group than in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Probiotics combined with meropenem can effectively improve the clinical efficacy of cirrhosis complicated with SBP,inhibit the secretion of inflammatory factors,improve the intestinal mucosal barrier function of patients,and have a high safety.

关 键 词：美罗培南 益生菌 自发性细菌性腹膜炎 肠黏膜屏障 炎症因子 

分 类 号：R575.2[医药卫生—消化系统] R656.41[医药卫生—内科学]