CAJ | 학술논문

目的采用益生菌制剂对胆汁淤积性肝病患儿进行治疗,以了解其对肠道菌群及相关细胞因子的影响.方法 1.将2010年10月至2011年6月在广西医科大学第一附属医院住院的84例胆汁淤积性肝病患儿采用简单数字表随机法分成益生菌干预组和非干预组.采用SYBR Green Ⅰ型实时荧光定量聚合酶链反应检测肠道细菌,比较益生菌干预组与非干预组肠道3种代表细菌数量的变化.2.检测2组治疗前后肝功能、血氨水平、胆固醇等指标;同时采用酶链免疫吸附试验测定血清转化生长因子-β1、肿瘤坏死因子-α(TNF-α)和白细胞介素-6 (IL-6)3种细胞因子水平.结果 1.益生菌干预组治疗前后比较,粪便中双歧杆菌、乳酸杆菌及双歧杆菌/大肠杆菌比值(B/E)均显著增加(P均＜0.01),大肠杆菌数量减少(P＜0.05);非干预组双歧杆菌、乳酸杆菌、大肠杆菌数量及B/E差异均无统计学意义(P均＞0.05).2.2组治疗后总胆红素、结合胆红素、γ-谷氨酰转移酶、丙氨酸转移酶、总胆汁酸、血氨、碱性磷酸酶水平均有好转(P均＜0.05);益生菌干预组治疗后TNF-α及IL-6水平下降(t=7.31,P =0.00;t-2.90,P=0.01),非干预组中差异无统计学意义;且血氨水平在益生菌干预组下降更明显(t=-8.37,P=0.00).3.B/E与IL-6水平呈负相关(r=-0.796,P=0.01).结论益生菌制剂干预治疗对胆汁淤积性肝病肠道菌群的恢复和免疫平衡具有一定的作用.
목적 채용익생균제제대담즙어적성간병환인진행치료,이료해기대장도균군급상관세포인자적영향.방법 1.장2010년10월지2011년6월재엄서의과대학제일부속의원주원적84례담즙어적성간병환인채용간단수자표수궤법분성익생균간예조화비간예조.채용SYBR Green Ⅰ형실시형광정량취합매련반응검측장도세균,비교익생균간예조여비간예조장도3충대표세균수량적변화.2.검측2조치료전후간공능、혈안수평、담고순등지표;동시채용매련면역흡부시험측정혈청전화생장인자-β1、종류배사인자-α(TNF-α)화백세포개소-6 (IL-6)3충세포인자수평.결과 1.익생균간예조치료전후비교,분편중쌍기간균、유산간균급쌍기간균/대장간균비치(B/E)균현저증가(P균＜0.01),대장간균수량감소(P＜0.05);비간예조쌍기간균、유산간균、대장간균수량급B/E차이균무통계학의의(P균＞0.05).2.2조치료후총담홍소、결합담홍소、γ-곡안선전이매、병안산전이매、총담즙산、혈안、감성린산매수평균유호전(P균＜0.05);익생균간예조치료후TNF-α급IL-6수평하강(t=7.31,P =0.00;t-2.90,P=0.01),비간예조중차이무통계학의의;차혈안수평재익생균간예조하강경명현(t=-8.37,P=0.00).3.B/E여IL-6수평정부상관(r=-0.796,P=0.01).결론 익생균제제간예치료대담즙어적성간병장도균군적회복화면역평형구유일정적작용.
Objective To explore the effects of application of probiotics on intestinal flora and related cytokines in infants with cholestatic liver disease.Methods (1) Eighty-four infants with cholestatic liver disease had been hospitalized from October 2010 to June 2011 in the First Hospital of Guangxi Medical University.The infants with cholestatic liver disease were randomly divided into the probiotic intervention group and the non-probiotic intervention group.Quantification of intestinal bacteria was detected by SYBR Green Ⅰ real-time fluorescent quantitative polymerase chain reaction,then the number of 3 kinds of bacteria before and after the treatment was compared.(2) The indices of liver function,blood ammonia,cholesterol were detected.The levels of serum transforming growth factor-β1,tumor necrosis factor-α(TNF-α)and interleukin-6 (IL-6) were measured by enzyme linked immunosorbent assay.Results (1) The number of bifidobacterium,lactobacillus and bifidobacterium/escherichia coli (B/E) were significantly increased (all P ＜ 0.01),whereas the number of escherichia coli was significantly decreased in the probiotic intervention group(P ＜ 0.05),however,there were no differences in the non-probiotic intervention group(all P ＞ 0.05).(2)The indices of total billirubin,direct billirubin,γ-Glutamyltransferase,total bile acid,alanine aminotransferase,blood ammonia,alkaline phosphatase were significantly improved after therapy in 2 groups (all P ＜ 0.05).The levels of TNF-α and IL-6 were significantly decreased in the probiotic intervention group (t--7.31,P =0.00;t =-2.90,P =0.01),but there were no differences in the non-probiotic intervention group.The level of BA was significantly decreased in the probiotic intervention group than the non probiotic intervention group (t =-8.37,P =0.00).(3) The B/E value were significantly inverse correlated with level of serum IL-6 (r =-0.796,P =0.01).Conclusions It may help to restore the intestinal flora and balance the immune function in infants with cholestatic liver disease after application of probiotics.