美常安联合乳果糖对重型肝炎患者肠黏膜屏障功能的影响

目的探讨枯草杆菌二联活菌肠溶胶囊（美常安）联合乳果糖对重型肝炎患者肠黏膜屏障功能的影响。方法 43例重型肝炎患者随机分为对照组（19例）和治疗组（24例）,两组均给予美常安口服;治疗组加用乳果糖口服液。所有患者均于治疗前后测定内毒素（ETX）含量、血氨及胆红素等其他指标,另选12例健康体检者作为正常对照组。结果治疗组及对照组治疗后血清总胆红素等指标均较治疗前有明显下降,不适症状亦有明显改善;两组血清治疗前ETX水平、血氨水平均高于正常对照组,差异有统计学意义（P〈0.05）;两组患者治疗后血清ETX水平、血氨水平较治疗前水平下降,治疗组下降较对照组下降更明显,差异有统计学意义（P〈0.05）。结论重型肝炎患者血清ETX水平、血氨水平高于正常人,肠黏膜屏障功能下降;口服补充肠道益生菌可改善肠黏膜屏障功能,乳果糖联合美常安可保护肠黏膜屏障功能,显著降低重型肝炎患者血氨水平。

Influence of Medilac-s combined with lactulose on intestinal mucosal barrier function of severe hepatitis patients

Objective To investigate the influence of live combined bacillus subtilis and enterococcus faecium enteric-coated capsules（Medilac-s） combined with lactulose on intestinal mucosal barrier function of severe hepatitis patients. Methods A total of 43 severe hepatitis patients were randomly divided into control group with 19 cases and treatment group with 24 cases, and the two groups received oral administration of Medilac-s. The treatment group received additional lactulose oral liquid for treatment. The levels of endotoxin（ETX）, blood ammonia, and bilirubin of the patients were detected before and after treatment. Another 12 healthy people were enrolled as the normal control group. Results The levels of total serum bilirubin and other indexes were decreased in the treatment and control groups, compared with those before treatment, and the discomfort symptom was improved. Both groups had higher levels of ETX and blood ammonia than the normal control group before treatment, and the difference had statistical significance（P〈0.05）. After treatment, the levels of ETX and blood ammonia were much lower than those before treatment, and the decrease in the treatment group was much more obvious than that in the control group, and the difference had statistical significance（P〈0.05）. Conclusion The levels of ETX, blood ammonia, and bilirubin of severe hepatitis patients are higher than those of health people, and their intestinal mucosal barrier function declines. The supplement of intestinal probiotics through oral administration can improve intestinal mucosal barrier function, which can be protected by the combination of Medilac-s and lactulose. This treatment can also significantly reduce the level of blood ammonia in severe hepatitis patients.