微生態制劑對肝硬化患者腸道菌群及內毒素水平干預療效觀察

【摘要】 目的 探討微生態制劑對肝硬化患者腸道菌群、內毒素水平的干預作用及療效。

方法選擇肝硬化患者57例，另選取24例健康體檢者作為健康組，將57例肝硬化患者隨機分為對照組25例，觀察組32例，兩組均采用常規護肝利尿治療，觀察組在此基礎上，加用雙歧桿菌三聯活菌膠囊治療8周，分別測定治療前各組及治療后兩疾病組腸道10種細菌菌落數和內毒素水平。并對比兩疾病組治療前后并發癥的變化情況。結果 治療前肝硬化患者的內毒素水平顯著高于健康體檢者（P＜0.01），腸道菌群中的雙歧桿菌、乳桿菌、腸桿菌顯著低于健康體檢者（P＜0.05或0.01），葡萄球菌、梭菌顯著高于健康體檢者（P＜0.01）。治療前兩疾病組內毒素水平及各腸道菌群菌落數比較差異無統計學意義（P均＞0.05），治療后對照組內毒素水平無顯著變化（P＞0.05），觀察組內毒素水平顯著低于治療前（P＜0.01）；對照組中腸桿菌、真桿菌較治療前顯著下降（P＜0.05或0.01），觀察組中腸桿菌、雙歧桿菌、乳桿菌、擬桿菌較治療前顯著升高，葡萄球菌、梭菌較治療前顯著降低（P＜0.05或0.01），其中治療后觀察組的雙歧桿菌、乳桿菌菌落數顯著高于對照組（P＜0.05或0.01）。治療前后比較，觀察組的并發癥發生率顯著降低（P＜0.01），對照組無改變。結論微生態制劑能調節腸道菌群狀態，提高腸道有益菌如雙歧桿菌含量，降低內毒素水平，對降低肝硬化并發癥發生率、改善預后具有重要的臨床意義。

【關鍵詞】 內毒素；腸道菌群；微生態制劑；肝硬化

文章編號：1003-1383(2010)06-0659-03 中圖分類號：R 575.2文獻標識碼：A

doi:10.3969/j.issn.1003-1383.2010.06.003

Study on the effect of microecologial agents in the intestinal flora and endotoxin level of patients with liver cirrhosis

CHEN Yuping，ZHONG Zhuanhua，LIANG Yuehuan，WANG An

(The People's Hospital of Zhuhai，Guangdong Zhuhai，519000，China)

【Abstract】 Objective To investigate the effect of microecological agents on the intestinal flora and endotoxin level of patients with liver cirrhosis.

Methods 57 patients with liver cirrhosis and 24 healthy participants were chosen. 57 patients with cirrhosis were randomly divided into control group(25 cases) and treatment group(32 cases)，both groups were treated with conventional diuretic liver，the treatment group was added bifidobacterium triple viable capsule for 8 weeks.10 colonies number and endotoxin levels were measured in three groups pre and post treatment.

Results Endotoxin levels in cirrhotic patients was significant higher than healthy group (P＜0.01)，the colonies number of bifidobacteria，Lactobacillus and enterobacteriaceae in the intestinal flora were significant lower than healthy group(P＜0.05 or 0.01)，the colonies number of staphylococcus aureus and Fusobacterium was significant higher than healthy group before treatment(P＜0.01). Endotoxin levels and the number of colonies of intestinal flora was no significant difference before treatment (P＞0.05)， there was no significant difference of the levels of endotoxin in the control group after treatment(P＞0.05)，while the level of Endotoxin in the treatment group was significantly lower(P＜0.01);the level of Enterobacteriaceae and Eubacterium was significant lower in control group(P＜0.05 or 0.01)，the level of Bifidobacterium，Lactobacillus and Eubacterium increased significantly，staphylococci were significant lower in treatment group(P＜0.05 or 0.01)，while the colony count of Bifidobacterium and Lactobacillus bacteria were significant larger in treatment group(P＜0.05 or 0.01).The complication rate of the treatment group were significantly lower after treatment comparing to before treatment(P＜0.01)， no change was found in control group.

Conclusion Microecological agents can effectively regulate the condition of intestinal flora， enhancing the content of beneficial bacterium，such as bifidobacteria，declining the level of endotoxin，and exert considerable clinical significance in hepatocirrhosis treatment in bringing down the incidence of complication and improving the prognosis.

【Key words】microecological agents；intestinal flora；endotoxin；liver cirrhosis

肝硬……