摘要
目的探讨嗜酸乳杆菌对轮状病毒腹泻患儿内皮糖萼损伤的影响。方法选取徐州医科大学附属徐州儿童医院收治的轮状病毒感染患儿作为研究对象,共122例。采用随机数字表法将患儿分为对照组和观察组,每组61例。对照组采用蒙脱石散治疗,观察组则在对照组的治疗基础上联合复方嗜酸乳杆菌片治疗。测定治疗前后2组患儿血管糖萼损伤标志物〔多配体蛋白聚糖-1(syndecan-1)、硫酸乙酰肝素(HS)〕、血管生成因子〔促血管生成素(Ang)-1、Ang-2及其特异性受体Tie-2〕、肠功能指标〔血清二胺氧化酶(DAO)、D-乳酸(DLA)、尿乳果糖与甘露醇(L/M)比值〕、炎性因子〔肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-18〕水平,检测舌下微循环血管内皮糖萼厚度,比较2组患儿的临床疗效及不良反应发生情况。结果与治疗前及对照组比较,观察组患儿治疗后syndecan-1和HS水平降低,Ang-1水平升高,Ang-2、Tie-2水平降低,血管内皮糖萼厚度增加,TNF-α、IL-6、IL-18水平降低(均P<0.05)。与治疗前比较,治疗后2组患儿D-LA、DAO、L/M水平均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组的总有效率高于对照组,不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论嗜酸乳杆菌可有效改善轮状病毒腹泻患儿的临床症状,其治疗机制可能与促进Ang-1与受体Tie-2结合、增强Ang-1/Tie-2信号通路有关。
Objective To explore the effects of Lactobacillus acidophilus on endothelial glycocalyx injury in children with rotavirus diarrhea.Methods A total of 122 children who were admitted into Xuzhou Children’s Hospital Affiliated to Xuzhou Medical University due to rotavirus infection were enrolled.According to the random number table method,they were divided into two groups(n=61):a control group and an observation group.The control group was administered with montmorillonite powder,while the observation group was additionally given Lactobacillus acidophilus.Then,their levels of glycocalyx injury markers[syndecan-1,heparan sulfate(HS)],vascular growth factors[angiopoietin(Ang)-1,Ang-2,and its specific receptor Tie-2],bowel function indicators[D-lactic acid(LA),serum diamine oxidase(DAO),and urinary lactulose/mannitol(L/M)ratio],and inflammatory factors[tumor necrosis factor(TNF)-α,interleukin(IL)-6,and IL-18],as well as endothelial glycocalyx thickness were detected before and after treatment.Both groups were compared for clinical effectiveness and adverse reactions.Results Compared with those before treatment and the control group,the observation group showed decreases in syndecan-1 and HS,increases in Ang-1,decreases in Ang-2 and Tie-2,increases in endothelial glycocalyx thickness and decreases in TNF-α,IL-6 and IL-18(each P<0.05).After treatment,both groups presented remarkable decreases in the levels of D-LA,DAO and L/M ratio compared with those before treatment,in which the observation group produced lower levels of D-LA,DAO and L/M ratio than the control group(P<0.05).The observation group presented a higher rate of total effectiveness and a lower rate of adverse reactions than the control group(P<0.05).Conclusions Lactobacillus acidophilus can effectively improve the clinical symptoms of children with rotavirus diarrhea,which may associated with stimulating the combination of Ang-1 and Tie-2 receptor and enhancing the Ang-1/Tie-2 signaling system.
作者
王光猛
封东进
周琦
WANG Guangmeng;FENG Dongjin;ZHOU Qi(Department of Gastroenterology,Xuzhou Children's Hospital Affiliated to Xuzhou Medical University,Xuzhou,Jiangsu 221002,China)
出处
《徐州医科大学学报》
CAS
2021年第1期57-61,共5页
Journal of Xuzhou Medical University
基金
国家自然科学基金(81500977)。
