摘要
背景：肝硬化患者易并发自发性腹膜炎、肝性脑病、感染性休克等并发症,与肠黏膜屏障功能受损、肠道菌群紊乱密切相关.目的：探讨谷氨酰胺（Gln）联合益生菌对肝硬化患者肠黏膜屏障和肝功能的影响.方法：选取2011年4～12月安徽省蚌埠医学院第一附属医院收治的肝硬化患者80例,随机分为Gln组、益生菌组、联合组、对照组,各组给予相同的常规保肝、利尿治疗,Gln组、益生菌组、联合组在常规治疗的基础上给予相应药物.Gln组：复方Gln肠溶胶囊400 mg tid,疗程14 d;益生菌组：酪酸梭菌二联活菌散1 500 mg tid,疗程14 d;联合组：复方Gln肠溶胶囊400 mg tid＋酪酸梭菌二联活菌散1 500 mg tid,疗程14 d.试验第1、14 d采用Child-Pugh分级标准评估肝功能;以活性比色法定量检测血清二胺氧化酶（DAO）水平;以显色基质鲎试剂检测血清内毒素水平;以改良的酶学分光光度法检测血清D-乳酸水平;以全自动生化仪检测血清AST、ALT水平.结果：治疗14 d后,Gln组、益生菌组、联合组的血清DAO、内毒素、D-乳酸水平均较治疗前显著下降（P＜0.05）,Gln组、益生菌组、联合组的血清内毒素、D-乳酸水平均较对照组显著下降（P＜0.05）,且联合组又明显低于Gln组和益生菌组（P＜0.05）.治疗14 d后,联合组的Child-Pugh评分较治疗前显著下降（P＜0.01）;联合组的Child-Pugh评分、血清AST、ALT水平均较其余三组显著下降（P＜0.05）.结论：Gln与益生菌联合应用可有效改善肝硬化患者的肠黏膜屏障功能和肝功能.
Background： Patients with liver cirrhosis are often complicated with spontaneous peritonitis, hepatic encephalopathy and septic shock, and this is often related to damage of intestinal mucosal barrier function and changes in intestinal microbiota. Aims： To study the effect of glutamine （Gin） and probiotics on intestinal mucosal harrier and liver function in patients with liver cirrhosis. Methods： A total of 80 patients with liver cirrhosis from April to December 2011 at The First Affiliated Hospital of Bengbu Medical College were enrolled in this study. Patients were randomly assigned into Gln group, probiotics group, combination group and control group. All patients were given conventional hepatoprotection and diuresis treatment. Gln, probiotics and combination groups received Gin, probiotics and Gln＋ probiotics in addition to conventional treatment, respectively. Gin group： Gln 400 mg tid for 14 days; probiotics group： Clostridium Butyricum and Bifidobacterium 1 500 mg tid for 14 days ; combination group ： Gin 400 mg tid ＋ Clostridium Butyricum and Bifidobacterium 1 500 mg tid for 14 days. Liver function was assessed by Child-Pugh score, serum level of diamine oxidase （DAO） was determined by colorimetric quantitative assay, serum level of endotoxin was determined by limulus test, serum level of D- lactic acid was determined by improved enzymatic spectrophotometry and serum levels of AST and ALT were determined by automatic biochemical analyzer at the 1^st and 14th day of the study. Results： After 14 days treatment, serum levels of DAO, endotoxin and D-lactic acid were significantly decreased in Gin, probiotics and combination groups when compared with those before treatment （ P 〈 0.05）, and serum levels of endotoxin and D-lactic acid were significantly lower than those in control group （P 〈0.05 ）, and those in combination group were significantly lower than those in Gin and probiotics groups （P 〈 0.05 ）. Child-Pugh score in combination group was decreased significantly after 14 days treatment （ P 〈 0.01 ）. Child-Pugh score, serum levels of AST and ALT were significantly lower in combination group than those in the other three groups （ P 〈 0.05）. Conclusions： Gin combined with probiotics might improve intestinal mucosal barrier and liver function in patients with liver cirrhosis.
出处
《胃肠病学》
2014年第4期213-216,共4页
Chinese Journal of Gastroenterology
关键词
谷氨酰胺
有益菌种
肝硬化
肠黏膜
肝功能
Glutamine
Probiotics
Liver Cirrhosis
Intestinal Mucosa
Liver Function
