酪酸梭菌活菌辅助硫普罗宁和美他多辛治疗酒精性肝病患者疗效及其对患者肠道菌群分布的影响

doi:10.3969/j.issn.1672-5069.2021.01.020

摘要/Abstract

摘要： 目的探讨应用酪酸梭菌活菌片辅助硫普罗宁和美他多辛治疗酒精性肝病(ALD)患者的疗效及对血清糖缺失性转铁蛋白(CDT)和肝细胞生长因子(HGF)水平及肠道菌群分布的影响。方法 2018年6月～2019年12月我院消化内科收治的102例ALD患者,采用随机数字表法分为对照组51例和观察组51例,分别给予硫普罗宁片和美他多辛片口服治疗或在此基础上予以酪酸梭菌活菌片口服治疗,两组均连续治疗观察12 w。采用ELISA法检测血清CDT、HGF、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、核因子-кB水平(NF-кB);使用Celsis R Advance II TM快速微生物检测系统检测粪便双歧杆菌、乳杆菌、大肠埃希菌和粪肠球菌。结果在治疗12 w末,观察组血清CDT水平为(580.2±74.2)pg/mL,显著低于对照组【(815.2±81.4)pg/mL,P<0.05】,血清HGF水平为(150.7±18.4)pg/mL,显著低于对照组【(390.5±40.2)pg/mL,P<0.05】;观察组粪便双歧杆菌水平为(8.7±2.6)lg CFU/g,显著高于对照组【(7.8±1.9)lg CFU/g,P<0.05】, 乳杆菌水平为(9.1±1.1)lg CFU/g,显著高于对照组【(8.5±1.7)lg CFU/g,P<0.05】,而大肠埃希菌水平为(6.5±1.6)lg CFU/g,显著低于对照组【(7.6±1.8)lg CFU/g,P<0.05】,粪肠球菌水平为(6.8±2.0)lg CFU/g,也显著低于对照组【(7.9±1.5)lg CFU/g,P<0.05】;血清IL-6水平为(0.7±0.1)pg/mL,显著低于对照组【(0.9±0.2)pg/mL,P<0.05】,血清TNF-α水平为(5.2±1.6)ng/L,显著低于对照组【(8.0±1.9)ng/L,P<0.05】,血清NF-кB水平为(1.2±0.3)ng/L,显著低于对照组【(2.7±1.0)ng/L,P<0.05】。结论应用酸梭菌活菌片辅助硫普罗宁和美他多辛治疗酒精性肝病患者可有效改善肠道菌群分布,抑制炎症反应,可能与降低了血清CDT和HGF水平有关。

关键词: 酒精性肝病, 酪酸梭菌活菌, 硫普罗宁, 美他多辛, 糖缺失性转铁蛋白, 肝细胞生长因子, 肠道菌群, 治疗

Abstract: Objective The aim of this study was to investigate the short-term efficacy of live clostridium butyricum in assisting tiopronin and metadoxine in the treatment of patients with alcoholic liver disease(ALD) and their effects on serum levels of glucose-deficient transferrin (CDT) and hepatocyte growth factor (HGF) as well as intestinal flora distribution. Methods 102 patients with ALD were admitted to the Department of Gastroenterology in our hospital between June 2018 and December 2019, and were randomly divided into control (n=51) and observation group (n=51), receiving tiopronin and metodoxine orally or liver clostridium butyricum orally at base of the two agents for 12 weeks. Serum CDT and HGF, interkeukin-6 (IL-6), tumor necrosis factor-α(TNF-α) and nuclear factor-кB (NF-кB) were detected by ELISA, and fecal bacteria flora were also detected. Results At the end of 12 week treatment, serum CDT level in the observation group was (580.2±74.2) pg/mL, significantly lower than , serum HGF level was (150.7±18.4) pg/mL, significantly lower than [(390.5±40.2) pg/mL, P<0.05] in the control; the distribution of Bifidobacterium in the observation group was (8.7±2.6) lg CFU/g, which was much higher than , that of Lactobacillus was (9.1±1.1) lg CFU/g, which was significantly higher than in the control, while the distribution of Escherichia Coli was (6.5±1.6) lg CFU/g, significantly lower than , and that of Enterococcus Faecalis was (6.8±2.0) lg CFU/g, also significantly lower than in the control; serum IL-6 level was (0.7±0.1) pg/mL, significantly lower than , serum TNF-α level was (5.2±1.6) ng/L, much lower than , and serum NF-кB level was (1.2±0.3) ng/L, significantly lower than in the control.Conclusion The application of live clostridium butyricum in assisting tiopronin and metadoxine in the treatment of patients with ALD could effectively improve intestinal flora distribution, inhibit inflammatory reaction, which might be related to the reduction of serum CDT and HGF levels.

Key words: Alcoholic Liver disease, Live clostridium butyricum, Tiopronin, Metadoxine, Sugar-deficient transferrin, Hepatocyte growth factor, Intestinal flora, Therapy

伍畅, 田园, 刘洪岩. 酪酸梭菌活菌辅助硫普罗宁和美他多辛治疗酒精性肝病患者疗效及其对患者肠道菌群分布的影响[J]. 实用肝脏病杂志, 2021, 24(1): 75-78.

Wu Chang,Tian Yuan,Liu Hongyan. Short-term efficacy of live clostridium butyricum in assisting tiopronin and metadoxine in treatment of patients with alcoholic liver disease[J]. Journal of Practical Hepatology, 2021, 24(1): 75-78.

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