摘要
目的探究双歧杆菌四联活菌辅助治疗在乙型肝炎肝硬化失代偿期(cirrhosis portal hypertension due to hepatitis B virus,CP-HBV)患者中的效果。方法选取2020年10月—2023年9月郑州人民医院收治的CP-HBV患者68例,根据治疗方法分为对照组、联合组,其中予以恩替卡韦的33例为对照组,予以恩替卡韦+双歧杆菌四联活菌的35例为联合组。比较两组不良反应发生率、治疗前后肝功能[总胆红素(total bilirubin,TBIL)、谷丙转氨酶(alanine aminotransferase,ALT)、γ-谷氨酰转移酶(γ-glutamyltransferase,GGT)、谷草转氨酶(aspartate aminotransferase,AST)]、肠黏膜屏障功能[尿乳果糖/甘露醇(rine lactulose/mannitol,L/M)比值、二胺氧化酶(diamine oxidase,DAO)、内毒素(endotoxin,LPS)]、肠道菌群(乳酸杆菌、大肠埃希菌、双歧杆菌、酵母菌)及血清炎症因子[可溶性细胞间黏附分子-1(soluble intercellular adhesion molecule-1,sICAM-1)、白介素-1(interleukin,IL-1)、Tol样受体4(Tol-like receptor 4,TLR-4)、肿瘤坏死因子-α(tumor necrosis factor,TNF-α)]水平。结果联合组治疗后TBIL、ALT、GGT、AST水平低于对照组,差异具有统计学意义(P<0.05);联合组治疗后L/M、DAO、LPS水平低于对照组(P<0.05);联合组治疗后乳酸杆菌、双歧杆菌水平升高幅度大于对照组,大肠埃希菌、酵母菌水平降低幅度大于对照组,差异具有统计学意义(P<0.05);联合组治疗后sICAM-1、IL-1、TLR-4、TNF-α水平低于对照组(P<0.05);两组不良反应发生率相比,无显著差异(P>0.05)。结论双歧杆菌四联活菌辅助治疗CP-HBV,不仅可改善肝功能、修复肠黏膜屏障功能,还可调节肠道菌群,减轻体内炎症反应,且安全可靠。
Objective To investigate the efficacy of adjunctive therapy with quadruple viable bifidobacteria in patients with cirrhosis portal hypertension due to hepatitis B virus(CP-HBV).Methods A total of 68 patients with CP-HBV who were treated in People's Hospital of Zhengzhou from October 2020 to September 2023 were selected and divided into a control group and a combined group according to different treatment methods.Among them,33 cases who received conventional treatment(entecavir)were in the control group,and 35 cases who received entecavir+bifidobacterium quadruple viable bacteria were in the combined group.The incidence of adverse reactions were compared between the two groups,as well as liver function[total bilirubin(TBIL),alanine aminotransferase(ALT),γ-glutamyltransferase(GGT),aspartate aminotransferase(AST)],intestinal mucosal barrier function[urine lactulose/mannitol(L/M)ratio,diamine oxidase(DAO),endotoxin(LPS)],intestinal flora(Lactobacillus,Escherichia coli,Bifidobacteria,yeast),and serum inflammatory factors[soluble intercellular adhesion molecule-1(sICAM-1),interleukin-1(IL-1),Tol-like receptor 4(TLR-4),tumor necrosis factor-α(TNF-α)]levels before and after treatment.Results After treatment,the levels of TBIL,ALT,GGT,and AST in the combined group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of L/M,DAO,and LPS in the combined group were lower than those in the control group(P<0.05).After treatment,the levels of lactobacillus and bifidobacteria in the combined group were increased more than those in the control group,while the levels of Escherichia coli and yeast were decreased more than those in the control group,and the difference was statistically significant(P<0.05).The levels of sICAM-1,IL-1,TLR-4,and TNF-α in the combined group after treatment were lower than those 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 The treatment of CP-HBV with bifidobacterium quadruple viable bacteria not only improves liver function and restores intestinal mucosal barrier function,but also regulates intestinal flora and reduces inflammatory response in the body,which is safe and reliable.
作者
郭云霞
张意兰
杨娇楠
韩莉
丁蒙蒙
杨丽
GUO Yun-xia;ZHANG Yi-lan;YANG Jiao-nan;HAN Li;DING Meng-meng;YANG Li(Department of Gastroenterology,Peoples Hospital of Zhengzhou,Zhengzhou 450000,China)
出处
《医药论坛杂志》
2025年第10期1090-1094,共5页
Journal of Medical Forum
关键词
双歧杆菌四联活菌
乙型肝炎肝硬化失代偿期
肠黏膜屏障功能
肠道菌群
Bifidobacterium quadruple viable bacteria
Decompensated hepatitis B cirrhosis
Intestinal mucosal barrier function
Intestinal flora
