粪菌移植联合益生菌治疗中度老年阿尔茨海默病患者临床疗效分析  

Clinical efficacy of fecal microbiota transplantation combined with probiotics for moderate elderly AD patients

作　　者：范顺太[1] 王婷[2] 闻公灵[3] Fan Shuntai;Wang Ting;Wen Gongling(Department of Neurology,First Affiliated Hospital of Nanyang Medical College,Nanyang473000,Henan Province,China)

机构地区：[1]南阳医学高等专科学校第一附属医院神经内科,473000 [2]南阳医学高等专科学校医学技术系 [3]南阳市中心医院神经内科

出　　处：《中华老年心脑血管病杂志》2025年第2期192-196,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20191461)。

摘　　要：目的探讨粪菌移植联合益生菌治疗对中度老年阿尔茨海默病(Alzheimer's disease,AD)患者认知功能及肠道屏障功能的影响。方法回顾性纳入2021年1月至2023年6月在南阳医学高等专科学校第一附属医院就诊的184例中度老年AD患者作为研究对象,按随机数字表法分为对照组92例和研究组92例,对照组给予盐酸美金刚治疗,研究组给予盐酸美金刚、粪菌移植联合益生菌治疗,比较2组患者治疗前后认知功能相关指标、炎性因子、氧化应激以及肠道屏障功能指标变化。结果对照组和研究组患者治疗后AD评定量表-认知分量表评分及日常生活活动能力量表评分较治疗前明显下降,简易智能状态检查量表评分明显升高,差异有统计学意义(P<0.05);研究组治疗后AD评定量表-认知分量表评分、日常生活活动能力量表评分显低于对照组,简易智能状态检查量表评分明显高于对照组,差异有统计学意义(P<0.01)。研究组治疗后肿瘤坏死因子α、白细胞介素6、白细胞介素8、丙二醛及同型半胱氨酸明显低于对照组[(9.1±2.1)ng/L vs(11.3±2.2)ng/L,P=0.027;(11.1±3.4)μg/L vs(16.5±3.1)μg/L,P=0.000;(21.0±4.7)μg/L vs(27.2±5.0)μg/L,P=0.000;(6.3±1.2)μmol/L vs(7.0±1.3)μmol/L,P=0.009;(38.2±4.8)μg/L vs(45.7±6.2)μg/L,P=0.000],研究组治疗后超氧化物歧化酶明显高于对照组[(104.3±8.9)U/L vs(80.2±7.5)U/L,P=0.000];研究组患者治疗后丙二醛及同型半胱氨酸较治疗前明显下降,超氧化物歧化酶较治疗前明显上升(P<0.05)。研究组治疗后内毒素、二胺氧化酶及尿乳果糖/甘露醇比值明显低于对照组,差异有统计学意义(P<0.05,P<0.01)。结论粪菌移植联合益生菌能明显改善中度老年AD患者的认知功能以及肠道屏障功能。Objective To explore the effect of fecal microbiota transplantation(FMT)combined with probiotics on cognitive function and intestinal barrier function in elderly patients with moderate Alzheimer's disease(AD).Methods A total of 184elderly patients with moderate AD admitted in the First Affiliated Hospital of Nanyang Medical College from January 2021to June 2023were enrolled,and randomly divided into control group(92cases)and study group(92cases).The control group received treatment with memantine hydrochloride,while the study group was given memantine hydrochloride and FMT combined with probiotics.The changes in cognitive function related indicators,inflammatory factors,oxidative stress and intestinal barrier function indicators were compared before and after treatment and between the two groups.Results After treatment,the ADAS-cog scores and Activities of Daily Living(ADL)score were significantly decreased,the scores of Simple Intelligence Status Examination Scale(SISES)was obviously in creased in both groups(P<0.05).The study group had notably lower ADAS-cog and ADL scores,and higher SISES score than the control group after treatment(P<0.01).The levels of TNF-α,IL-6,IL-8,MAD and homocysteine after treatment were notably lower(9.1±2.1ng/L vs 11.3±2.2ng/L,P=0.027;11.1±3.4μg/L vs 16.5±3.1μg/L,P=0.000;21.0±4.7μg/L vs 27.2±5.0μg/L,P=0.000;6.3±1.2μmol/L vs 7.0±1.3μmol/L,P=0.009;38.2±4.8μg/L vs 45.7±6.2μg/L,P=0.000),and SOD level was remarkably higher(104.3±8.9U/L vs 80.2±7.5 U/L,P=0.000)in the study group than the control group.In the study group,the levels of MAD and homocysteine were decreased,while that of SOD was increased after treatment(P<0.05).The levels of endotoxin,diamine oxidase,and urinary lactulose/mannitol ratio in the study group were significantly lower than those in the control group after treatment(P<0.05,P<0.01).Conclusion FMT combined with probiotics can significantly improve cognitive function and intestinal barrier function in elderly patients with moderate AD.

关 键 词：阿尔茨海默病 鼠李糖乳杆菌 粪菌移植 

分 类 号：R47[医药卫生—护理学]