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目的探讨微生态调节剂乐托儿(冻干灭活的嗜酸乳杆菌)对婴儿肝炎综合征(infantile hepatitis syndrome,IHS)肠道菌群及胆汁成分的影响。方法 2002年3月至2008年5月在华中科技大学同济医学院附属同济医院儿科住院的60例IHS为纳入研究对象,随机分为乐托尔组和对照组,随机方法为随机数字表法。患儿均给予熊去氧胆酸(25mg/次,日3次)及护肝治疗。乐托尔组口服乐托尔散剂(嗜酸乳杆菌散剂)每次1袋,2次/d;15d为1个疗程,连续2个疗程。对照组口服中和冻干培养基。监测两组患儿治疗前后血清和十二指肠引流液(胆汁)中总胆红素(TB)、结合胆红素(DB)、丙氨酸转氨酶(ALT)、γ-谷氨酰转肽酶(γ-GT)、总胆汁酸(TBA)水平及肠道菌群数量。采用SPSS10.0软件进行统计学分析。结果两个疗程结束后,乐托尔组总有效率为92.86%,对照组为74.07%,差异有统计学意义(P<0.05)。乐托尔组患儿血清中TB、DB、ALT、γ-GT、TBA与对照组比较均显著降低,差异有统计学意义(P<0.05)。乐托尔组肝脏明显缩小,差异有统计学意义(P<0.05)。十二指肠引流液中TB、DB、γ-GT、TBA与对照组比较均显著升高,差异有统计学意义(P<0.05)。对照组肠道菌群无明显变化,乐托尔组双歧杆菌、乳酸杆菌、粪肠球菌显著增加,差异有统计学意义(P<0.05)。两组均未见明显药物副反应。结论 IHS存在肠道菌群紊乱,微生态调节剂(冻干灭活的嗜酸乳杆菌)与熊去氧胆酸合用能促进胆汁酸排泄,改善肝功能及肠道菌群,在IHS的治疗中有明确的有效性。
Objective To investigate the effect of eczema (lyophilized Lactobacillus acidophilus), a microecological regulator, on intestinal flora and biliary components in infantile hepatitis syndrome (IHS). Methods From March 2002 to May 2008, 60 cases of IHS hospitalized in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology were enrolled in the study. They were randomly divided into two groups. The randomized method was random number table. Children were given ursodeoxycholic acid (25mg / time, 3 times a day) and liver treatment. Lettol group orally administered Lotto powder (Lactobacillus acidophilus powder) each time a bag, 2 times / d; 15d for a course of treatment for 2 courses. The control group was orally administered with lyophilized medium. The levels of total bilirubin (TB), bound bilirubin (DB), alanine aminotransferase (ALT), γ-glutamyl transpeptidase Enzyme (γ-GT), total bile acid (TBA) levels and intestinal flora. Using SPSS10.0 software for statistical analysis. Results After the two courses of treatment, the total effective rate was 92.86% in the control group and 74.07% in the control group, the difference was statistically significant (P <0.05). Serum levels of TB, DB, ALT, γ-GT and TBA in the children with lettol group were significantly lower than those in the control group, with significant difference (P <0.05). The liver of the Letel group was significantly reduced, the difference was statistically significant (P <0.05). The levels of TB, DB, γ-GT and TBA in the drainage fluid of duodenum were significantly increased compared with the control group (P <0.05). There was no significant change in the intestinal flora in the control group, and Bifidobacterium, Lactobacillus and Enterococcus faecalis increased significantly in the Letel group (P <0.05). No obvious side effects were observed in both groups. Conclusion Intestinal flora was disturbed in IHS. The combination of micro-ecological regulator (lyophilized Lactobacillus acidophilus) and ursodeoxycholic acid can promote bile acid excretion, improve liver function and intestinal microflora, and treatment of IHS There is a clear validity.