肠道益生菌制剂对肝硬化失代偿期患者肠黏膜的保护作用

目的：探讨肠道益生菌制剂对肝硬化失代偿期患者肠黏膜的保护作用。方法：收集肝硬化失代偿期患者82例,随机分为观察组和对照组,各组41例,另设正常组40例。对照组采用常规治疗方法,观察组在对照组基础上合用肠道益生菌制剂治疗,正常组不做任何处理,比较3组患者治疗前后肠道通透性、血内毒素水平（ETX）、肠道菌群变化情况。结果：治疗前对照组和观察组乳果糖（LAC）、LAC/甘露醇（MAN）、ETX均较正常组升高,MAN较正常组降低（P〈0.05）,观察组、对照组患者肠道内双歧杆菌、类杆菌、乳杆菌较正常组明显降低,梭菌、肠杆菌、酵母样真菌则明显升高（P〈0.05）;治疗后观察组LAC、LAC/MAN、ETX均较对照组明显降低（P〈0.05）,观察组双歧杆菌、类杆菌、乳杆菌、肠球菌明显高于对照组,肠杆菌、酵母样真菌明显低于对照组（P〈0.05）。结论：肠道益生菌制剂可明显改善肝硬化失代偿期患者的肠道通透性,减少ETX的生成,同时改善肠道菌群的微生态平衡,修复肠黏膜屏障,进而改善患者的预后,值得临床推广应用。

Protective effect of intestinal probiotics on intestinal mucosa of patients with loss compensatory stage of cirrhosis

Objective： To investigate the protective effect of intestinal probiotics on intestinal mucosa of patients with loss compensatory stage of cirrhosis. Methods： Eighty-two cases of patient with loss compensatory stage of cirrhosis were selected and randomly divided into observation group and control group,in each group there were 41 cases,normal group where there were 40 cases was set. Patients in control group were treated with conventional therapy,and patients in observation group were treated with intestinal probiotics on basis of control group,and normal group were not done any treatment,the changes of intestinal permeability,ETX level,intestinal flora before or after treatment among three groups were compared. Results： Before treatment,the LAC,LAC / MAN,ETX in observation group and control group were higher than those in normal group,the MAN was lower than that in normal group（ P〈0. 05）,the intestinal bifidobacterium,lactobacillus,bacteroides in observation group and control group were significantly lower than those in normal group,the clostridium,enterobacter,yeast-like fungi were increased significantly（ P〈0. 05）; after treatment,the LAC,LAC / MAN,ETX were lower than those in control group（ P〈0. 05）,the bifidobacterium,lactobacillus,bacteroides,enterococcus in observation group were significantly higher than those in control group,the intestinal bacteria,yeasts were significantly lower than those in control group（ P〈0. 05）. Conclusion： Intestinal probiotics can significantly improve the intestinal permeability of patients with loss compensatory stage of cirrhosis,reduce ETX production,at the same time,improve intestinal flora microecology balance,repair intestinal mucosa barrier,and then improve patient＇s prognosis,it is worthy of clinical application.