益生菌联合复方谷氨酰胺预防肝硬化失代偿期患者发生自发性细菌性腹膜炎的临床疗效研究

目的 探讨益生菌联合复方谷氨酰胺预防肝硬化失代偿期患者发生自发性细菌性腹膜炎（spontaneous bacterial peritonitis,SBP）的临床疗效.方法 以笔者医院2012年10月～2013年8月收治的64例肝硬化失代偿期患者为研究对象,随机平均分为治疗组和对照组.对照组采用常规护肝利尿补充白蛋白治疗;治疗组在对照组基础上加用培菲康及复方谷氨酰胺胶囊口服,疗程3个月.比较两组患者治疗后血浆内毒素（endotoxin,ET）、肿瘤坏死因子-α（tumor necrosis factor-alpha,TNF-α）及白介素6（interleukin-6,IL-6）的水平、Child-Pugh评分及两组SBP发生率等.结果 经过治疗后治疗组患者血浆ET、TNF-α及IL-6水平下降,差异有统计学意义（P＜0.05）,而对照组患者血浆ET、TNF-α及IL-6水平与治疗前相比,差异无统计学意义（P＞0.05）.治疗后两组Child-Pugh评分均好转,差异均有统计学意义（P＜0.05）,但治疗组统计学差异更显著（P＜0.01）.两组SBP发生率相比差异有统计学意义（P＜0.05）.结论 益生菌联合复方谷氨酰胺对肝硬化失代偿期患者SBP的发生有预防作用.

Effect of Probiotics Combined with Compound Glutamine on the Prevention of Spontaneous Bacterial Peritonitis in Patients with Decompensated Cirrhosis

Objective To investigate the effect of probiotics combined with compound glutamine on the prevention of SBP in patients with decompensated cirrhosis.Methods Sixty-four patients with with decompensated cirrhosis treated at our hospital from October 2012 to August 2013 were randomly divided into either a treatment group or a control group.On the basis of conventional treatment,such as hepatic functional protection treatment,diuresis and albumin administration,the treatment group was treated with probiotics combined with compound glutamine on the basis of conventional therapy.The levels of plasma endotoxin （ET）,tumor necrosis factor alpha （TNF-α）,interleukin 6 （IL-6）,Child-Pugh score and the incidences of SBP were compared between the two groups.Results The levels of plasma ET,TNF-α and IL-6 were lower in the treatment group than in the control group after treatment （P ＜ 0.05）,while in the control group,there were no statistically significant differences between before and after treatment （P ＞ 0.05）.After treatment Child-Pugh scores of the two groups were improved,and the differences were statistically significant （P ＜ 0.05）,and the result of treatment group was more significant （P ＜ 0.0l）.There was significant difference between the two groups in incidences of SBP （P ＜ 0.05）.Conclusion Probiotics combined with compound glutamine can effectively prevent spontaneous bacterial peritonitis in patients with decompensated cirrhosis.