微生态制剂对重型肝炎患者血清细胞因子的影响

目的 研究微生态制剂对重型肝炎患者临床症状、血清生物化学指标和细胞因子的影响. 方法 112例重型肝炎患者,随机分为治疗组58例和对照组54例,治疗组在内科综合治疗的基础上加用双歧杆菌、嗜酸乳杆菌、肠球菌三联活菌胶囊和乳果糖口服4周,对照组单用内科综合治疗.观察两组患者治疗前后的临床症状、肝功能改善情况,采用酶联免疫吸附法检测治疗前后肿瘤坏死因子(TNF)α、白细胞介素(IL)-2、-6、-10的水平.结果 治疗组临床症状和肝功能改善均优于对照组,血清TNFα、IL-6水平治疗组分别为(109.4±14.7)pg/ml和(84.3±20.1)pg/ml,对照组分别为(128.7±18.8)pg/ml和(109.1±18.7)pg/ml,治疗组比对照组明显降低,t值分别为2.924、2.996,P值均＜0.01,差异有统计学意义.IL-2、-10治疗组分别为(59.8±12.2)pg/ml和(30.6±6.6)pg/ml,对照组分别为(47.1±6.7)pg/ml和(22.5±6.1)pg/ml,治疗组比对照组明显升高,t值分别为2.979、3.055,P值均＜0.01,差异有统计学意义.结论 微生态制剂能降低TNFα、IL-6含量,升高IL-10、-2水平,抑制炎性介质的产生和减轻免疫反应对肝细胞的损伤,从而改善临床症状和肝功能.

Changes of plasma cytokines in patients with severe hepatitis treated with a probiotic preparation

OBJECTIVE: To study the changes of plasma cytokines in patients with severe hepatitis treated with a probiotic preparation. METHODS: One hundred twelve patients with severe hepatitis treated with a basic regimen were randomly divided into a probiotic preparation treatment group and a control group. Their plasma cytokines such as tumor necrosis factor alpha, interleukin-2, interleukin-6, interleukin-10, were determined by conventional techniques. RESULTS: Clinical symptoms of 84.5% of the treatment group were obviously improved. The treatment effectiveness in this group was better than that in the control group (X2=8.888). It showed that liver functions were significantly improved compared to those of the control group . After the probiotic preparation therapy, there were significant decreases in the concentrations of TNFa and IL-6. TNFa and IL-6 in the treatment group and in the control group were (109.4+/-14.7) pg/ml vs (128.7+/-18.8) pg/ml and (84.3+/-20.1) pg/ml vs (109.1+/-18.7) pg/ml respectively. However, the concentrations of IL-10 and IL-2 in the treatment group increased obviously: IL-2 was (59.8+/-12.2) pg/ml vs (47.1+/-6.7) pg/ml and IL-10 was (30.6+/-6.6) pg/ml vs (22.5+/-6.1) pg/ml. CONCLUSION: The probiotic preparation treatment effectively reduces the TNFa and IL-6 and increases the concentrations of IL-10 and IL-2 in the blood of the patients with severe hepatitis.