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【目的】探讨微生态制剂对非酒精性脂肪肝患者肝功能及胰岛素抵抗指数（HOMA‐IR）的影响。【方法】80例非酒精性脂肪肝患者随机分为两组，每组40例 。 对照组给予静脉滴注阿拓莫兰，同时口服多烯磷脂酰胆碱；观察组在对照组治疗基础上，给予枯草杆菌肠球菌二联活菌。 ELISA 法检测两组治疗前后血清肿瘤坏死因子‐α（TNF‐α）水平变化；全自动生化分析仪检测两组治疗前后肝功能指标，稳态模型评估 HOMA‐IR 。【结果】两组治疗后血清 TNF‐α、HOMA‐IR 、丙氨酸氨基转移酶（ALT ）、天冬氨酸氨基转移酶（AST ）、γ‐谷氨酰转肽酶（GGT ）、总胆红素（TBil）水平较治疗前均明显降低（ P ＜0．05），观察组降低的更加明显（ P ＜0．05） 。【结论】微生态制剂能够降低非酒精性脂肪肝患者血清 TNF‐α、HOMA‐IR 水平，改善肝功能。“,”Objective]To explore the clinical effects and mechanism of probiotics in patients with nonalco ‐holic fatty liver disease .[Methods] A total of 80 patients with nonalcoholic fatty liver disease were randomly divided into observation and control groups ( n = 40 each) .Control group received an intravenous drip of re‐duced glutathione plus an oral intake of polyene phosphatidyl choline .And treatment group had an additional intake of bacillus subtilis enterococcus duplex living bacterium .Enzyme‐linked immunosorbent assay (ELISA) was employed for detecting the changes of serum tumor necrosis factor‐alpha (TNF alpha) before and after treatment .And the levels of fasting glucose ,total cholesterol ,triglyceride and liver function parameters were recorded .The steady‐state model assessment of insulin resistance index (IR) was performed .[Results] The serum TNF alpha level significantly declined than before treatment ( P < 0 .05 ) .And IR significantly de‐creased than before treatment ( P < 0 .05) .In observation group after treatment ,serum level of TNF alpha and IR declined obviously compared with before treatment ( P < 0 .05) .After treatment ,the serum levels of ALT (alanine aminotransferase) ,AST (aspartate aminotransferase) ,GGT (gamma glutamyl transpeptidase) and TBil (total bilirubin) were significantly lower than those before treatment ( P < 0 .05) .The observation group declined more obviously ( P < 0 .05) .[Conclusion] Probiotics can lower the serum level of TNF and im‐prove liver function for patients with nonalcoholic fatty liver disease .