摘要
目的观察微生态制剂对肝性脑病患者肠道菌群及血氨的影响,并讨论其可能机制。方法选取42例确诊为肝性脑病的患者,随机分成对照组和治疗组,每组各21例,对照组给予常规综合治疗,治疗组在常规综合治疗的基础上给予口服微生态制剂治疗,在治疗前1d及治疗两周后分别检测并比较两组患者肠道菌群及血氨水平的变化;采用SPSS16.0软件进行统计分析,计量数据以均数±标准差表示,两组间均数比较用t检验。结果治疗前两组患者的肠道菌群及血氨水平无明显差异;对照组患者治疗前肠道菌群水平和治疗后无明显变化,差异无统计学意义,治疗后血氨水平下降,差异有统计学意义(P<0.05);治疗组患者治疗后乳杆菌属(9.68±0.85)lgCFU/g和肠球菌属的菌落数(11.06±1.11)lgCFU/g较治疗前显著增加,较对照组治疗后显著增加(P<0.01),治疗组患者酵母样真菌菌落数(3.51±0.43)lgCFU/g在治疗后较治疗前明显降低,亦较对照组治疗后明显降低(P<0.01);治疗后治疗组血氨水平(38.9±9.7)mmol/L较治疗前显著降低(P<0.01),较对照组治疗后亦降低(P<0.05)。结论在常规综合治疗的前提下,微生态制剂可增加肝性脑病患者肠道乳杆菌等益生菌,维持肠道微生态平衡,减少肠源性血氨的产生,从而减轻血氨对大脑的损害,临床疗效确切。
OBJECTIVE To observed the effects of micro-ecological agents on intestinal flora and blood ammonia of the patients with hepatic encephalopathy and explore the possible mechanisms. METHODS Totally 42 patients with confirmed hepatic ehcephalopathy were enrolled in the study and randomly divided into the control group and the treatment group, with 21 cases in each, then the control group was treated with conventional comprehensive thera- py, the treatment group was given the oral administration of micro-ecological agents on the basis of conventional comprehensive therapy, the changes of the intestinal flora and the level of blood ammonia were observed and com- pared respectively at one day before the treatment and two weeks after the treatment, the statistical analysis was performed with the use of SPSS16.0 software, the measurement data were defined as median ~ standard devia- tion, and the average number was compared between the two groups by means of the t-test. RESULTS Before the treatment, the intestinal flora and the level of blood ammonia did not show significant difference between the two groups; the level of intestinal flora of the control group did not show significant difference between before and af- ter the treatment, while the level blood ammonia was significantly decreased after the treatment, the difference was significant （P〈0.05）. After the treatment, the Lactobacillus colony counts of the treatment group were （9.68 ± 0.85） lgCFU/g, and the Enterococcus colony counts were （ 11.06 ± 1.11 ） lgCFU/g, significantly increased as compared with those before the treatment or with those of the control group （P〈0.01）. The yeast-like fungi colony counts of the treatment group were （3.51± 0.43）lgCFU/g, significantly decreased as compared with that before the treatment and with that of the control group （P（0.01）. The level of blood ammonia of the treatment group was （38. 9 ± 9. 7）mmol/L after the treatment, significantly decreased as compared with that before the treatment （P〈0.01） or with that of the control group （P〈0.05）. CONCLUSION On the basis of the conventional comprehensive therapy, the micro-ecological agents can increase the colony counts of probiotics such as intestinal Lactobacillus, maintain the intestinal micro-ecological balance, and reduce the enterogenic ammonia so as to miti- gate the brain damage due to the ammonia and achieve accurate clinical efficacy.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第10期2505-2507,共3页
Chinese Journal of Nosocomiology
基金
浙江省自然科学基金资助项目(Y2100716)
关键词
微生态制剂
肝性脑病
肠道菌群
血氨
Micro-ecological agent
Hepatic encephalopathy
Intestinal flora
Blood ammonia
