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目的探讨微生态制剂在改善肝硬化患者肠黏膜通透性、血内毒素水平、肠道菌群状态方面的作用及对肝硬化预后的影响。方法选择肝硬化患者57例,随机分为对照组25例,试验组32例,两组均采用常规护肝利尿治疗,试验组在此基础上,加用双歧杆菌三联活菌胶囊治疗8周,测定两组治疗前后肠道10种细菌菌落数、内毒素水平及尿乳果糖/甘露醇比值的变化。结果 (1)治疗后试验组内毒索水平、尿乳果糖/甘露醇比值明显低于治疗前及对照组治疗后水平,P<0.05。(2)试验纽治疗后肠道双歧杆菌、乳杆菌菌落数明显高于治疗前及对照组治疗后水平,P<0.05。(3)试验组治疗后并发症发生率明显低于治疗前,P<0.05;对照组治疗前后上述检测值无明显变化,P>0.05。结论微生态制剂通过调节肠道菌群状态,改善肠道机械屏障功能,降低肝硬化患者肠黏膜通透性,从而避免内毒素及细菌移位对器官功能的影响,对降低肝硬化并发症发生率、改善患者的预后具有重要的临床意义。
Objective To investigate the effect of probiotics on the improvement of intestinal mucosal permeability, blood endotoxin, intestinal microflora and liver cirrhosis prognosis in patients with liver cirrhosis. Methods Fifty-seven patients with cirrhosis were randomly divided into control group (n = 25) and experimental group (n = 32). Both groups were treated with routine hepatoprotective therapy. On the basis of this study, Bifidobacterium triple viable capsules The changes of intestinal microflora, endotoxin and urinary lactulose / mannitol ratio were measured before and after treatment. Results (1) After treatment, the level of endotoxin and the ratio of urine lactulose / mannitol in the experimental group were significantly lower than those before treatment and in the control group after treatment (P <0.05). (2) The intestinal tract Bifidobacterium and Lactobacillus colony number after trial treatment was significantly higher than before treatment and control group after treatment (P <0.05). (3) The incidence of complications after treatment in the experimental group was significantly lower than before treatment, P <0.05; before and after treatment in the control group, there was no significant change in the above test values (P> 0.05). Conclusions The probiotics can reduce the intestinal mucosal permeability of cirrhotic patients by regulating the state of intestinal flora, improving the mechanical barrier function of the intestine and thus avoiding the influence of endotoxin and bacterial translocation on organ function, and reducing the incidence of complications of liver cirrhosis Rate, improve the prognosis of patients with important clinical significance.