摘要
背景:肝硬化患者易发生多种感染,与免疫功能下降、肠道菌群紊乱有关。目的:观察口服微生态制剂对肝硬化患者细胞免疫功能、外周血单核细胞内毒素受体表达以及血清细胞因子和血浆内毒素水平的影响。方法:选取连续入院的肝硬化患者,予常规保肝治疗和口服微生态制剂4周,应用流式细胞术检测患者治疗前后外周血T细胞及其亚群和自然杀伤细胞、外周血单核细胞内毒素受体Toll样受体(TLR)4和CD14的表达,分别以酶联免疫吸附测定法和偶氮基质显色法检测细胞因子白细胞介素(IL)-1β、肿瘤坏死因子(TNF)-α、IL-10水平和血浆内毒素水平。结果:治疗前肝硬化患者外周血总T细胞(CD3)和CD4细胞数明显低于正常对照组(P<0.05),微生态制剂治疗后CD3和CD4亚群显著升高(P<0.05)。治疗前肝硬化患者外周血单核细胞内毒素受体TLR4和CD14的表达显著高于正常对照组(P<0.01),微生态制剂治疗后CD14表达显著降低(P<0.01),TLR4表达也呈下降的趋势,但差异无统计学意义。治疗前肝硬化患者血清IL-1β、TNF-α、IL-10水平显著高于正常对照组(P<0.05),微生态制剂治疗后血清细胞因子和血浆内毒素水平均无明显改变。结论:肝硬化患者存在细胞免疫功能下降和慢性炎症状态,微生态制剂可改善患者免疫功能的紊乱,因此可将其作为一种慢性肝病的辅助治疗。
The susceptibility to infection in patients with cirrhosis is related to the decrease in immune function and disturbance of intestinal microflora. Aims： To evaluate the effect of probiotics on cellular immune function, endotoxin receptors expression on peripheral blood mononuclear cells, serum cytokines and plasma endotoxin levels in patients with cirrhosis. Methods： Cirrhotic patients were treated with conventional liver protective therapy plus probiotics for 4 weeks. Peripheral blood T-lymphocyte and its subsets and natural killer cells, and expression of Toll-like receptor （TLR） 4 and CD14 on peripheral blood mononuclear cells were determined by flow cytometry. Serum levels of interleukin （IL）-1β, tumor necrosis factor （TNF）-α, IL-10 and plasma level of endotoxin were determined by enzyme-linked immunosorbent assay （ELISA） and chromogenic substrate assay, respectively. Results： Peripheral blood total T-lymphocytes （CD3） and CD4 T-lymphocyte subpopulation in patients with cirrhosis decreased significantly than those in healthy controls （P〈0.05）. After probiotics administration for 4 weeks, these parameters improved markedly （P〈0.05）. Expression of TLR4 and CD14 on peripheral mononuclear cells in cirrhotic patients increased significantly than those in healthy controls （P〈0.01）, after treatment there was a significant decrease in CD14 expression （P〈0.01） and a tendency of decrease in TLR4 expression. Serum levels of IL-1β, TNF-α and IL-10 in cirrhotic patients increased significantly than those in healthy controls （P〈 0.05）, but no significant differences were found in levels of cytokines and endotoxin after treatment. Conclusions： There are cellular immune dysfunction and chronic inflammation in patients with cirrhosis, and probiotics may improve these abnormalities. Probiotics may be considered as an adjunctive therapy in the treatment of chronic liver disease.
出处
《胃肠病学》
2007年第11期658-661,共4页
Chinese Journal of Gastroenterology
