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目的:探讨肠道益生菌制剂对肝硬化失代偿期患者肠黏膜的保护作用。方法:收集肝硬化失代偿期患者82例,随机分为观察组和对照组,各组41例,另设正常组40例。对照组采用常规治疗方法,观察组在对照组基础上合用肠道益生菌制剂治疗,正常组不做任何处理,比较3组患者治疗前后肠道通透性、血内毒素水平(ETX)、肠道菌群变化情况。结果:治疗前对照组和观察组乳果糖(LAC)、LAC/甘露醇(MAN)、ETX均较正常组升高,MAN较正常组降低(P<0.05),观察组、对照组患者肠道内双歧杆菌、类杆菌、乳杆菌较正常组明显降低,梭菌、肠杆菌、酵母样真菌则明显升高(P<0.05);治疗后观察组LAC、LAC/MAN、ETX均较对照组明显降低(P<0.05),观察组双歧杆菌、类杆菌、乳杆菌、肠球菌明显高于对照组,肠杆菌、酵母样真菌明显低于对照组(P<0.05)。结论:肠道益生菌制剂可明显改善肝硬化失代偿期患者的肠道通透性,减少ETX的生成,同时改善肠道菌群的微生态平衡,修复肠黏膜屏障,进而改善患者的预后,值得临床推广应用。
Objective: To investigate the protective effect of intestinal probiotics on intestinal mucosa in patients with decompensated liver cirrhosis. Methods: 82 patients with decompensated liver cirrhosis were randomly divided into observation group and control group, with 41 cases in each group and 40 cases in normal group. The patients in the control group received routine treatment. The patients in the observation group were treated with intestinal probiotics on the basis of the control group, without any treatment in the normal group. The changes of intestinal permeability, blood endotoxin (ETX) Road flora changes. Results: LAC, LAC / MAN and ETX in the control group and observation group before treatment were higher than those in the normal group and MAN were lower than those in the normal group (P <0.05). In the observation group and the control group, Bifidobacterium, Bacteroides and Lactobacillus were significantly lower than those in the normal control group, and Clostridium, Enterobacter, and yeast-like fungi were significantly increased (P <0.05). LAC, LAC / MAN and ETX in the observation group were significantly higher than those in the control group (P <0.05). The Bifidobacterium, Bacteroides, Lactobacillus and Enterococcus in the observation group were significantly higher than those in the control group. The Enterobacteriaceae and yeast-like fungi in the observation group were significantly lower than those in the control group (P <0.05). Conclusion: The intestinal probiotics can significantly improve the intestinal permeability and reduce the ETX production in patients with decompensated liver cirrhosis, improve the microbiological balance of intestinal flora, repair the intestinal mucosal barrier and further improve the prognosis ,Worthy of clinical application.