摘要
目的研究非酒精性脂肪性肝病(NAFLD)患者肠道菌群的变化以及双歧杆菌三联活菌胶囊对肠道菌群、肝功能、血脂及胰岛素抵抗的影响。方法随机选取2015年1月至2015年10月于本院确诊的NAFLD患者60例,采集粪便标本检测肠道菌群,同时在门诊健康体检者中随机选取40例作为健康对照组,比较NAFLD患者与健康对照者肠道菌群的变化情况。将NAFLD患者随机分为A组和B组,每组30例,其中A组给予口服多烯磷脂酰胆碱胶囊治疗,456 mg/次,3次/天,疗程30天;B组口服多烯磷脂酰胆碱胶囊(456 mg/次,3次/天)的同时口服双歧杆菌三联活菌胶囊(420 mg/次,3次/天),疗程30天。比较治疗前后各组患者粪便中肠道菌群及血清中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、血浆内毒素、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBil)、总胆固醇(TC)和甘油三酯(TG)水平的变化。应用稳态模型评估的胰岛素抵抗指数(HOMA-IR)分析肠道菌群与血浆内毒素水平的相关性。结果治疗前,NAFLD患者与健康对照组相比,双歧杆菌和乳杆菌的数量显著降低(t值分别为-2.320、2.875,P值分别为0.022、0.002),肠葡萄球菌和肠杆菌数量显著升高(t值分别为4.352、3.435,P值分别为0.000、0.001),肠球菌和拟杆菌无显著变化(t值分别为0.834、1.459,P值分别为0.401、0.173)。治疗后A组与B组双歧杆菌及乳杆菌的数量均有所上升,B组较A组上升更显著(t值分别为2.455、2.526,P值分别为0.027、0.018),两组治疗后肠葡萄球菌及肠杆菌数量显著下降,B组较A组下降更显著(t值分别为-2.049、2.758,P值分别为0.041、0.009)。治疗前NAFLD患者与健康对照者相比,血浆内毒素、TNF-α、IL-6和HOMA-IR均显著升高(t值分别为2.783、3.174、6.173和6.730,P值分别为0.006、0.002、0.000和0.000)。与A组相比,治疗后B组血浆内毒素、TNF-α、IL-6、HOMA-IR、ALT、AST、TBil及TG均显著下降(t
Objective To observe the changes of intestinal flora in patients with non-alcoholic fatty liver disease（NAFLD） and the effects of bifidobacterium triple viable capsules on intestinal flora, liver function, blood lipid and insulin resistance. Methods Total of 60 patients who were diagnosed as NAFLD from January 2015 to October 2015 in our hospital were randomly selected and the fecal samples were collected. Total of 40 healthy controls were randomly selected. The changes of intestinal flora in feces between the two groups were compared. Patients with NAFLD were randomly divided into two subgroups（group A and group B）, 30 cases in each group. Patients in group A were treated with polyene phosphatidyl choline orally, 456 mg/time, 3 times daily for 30 days; patients in group B were treated with polyene phosphatidyl choline capsules orally, 456 mg/time, 3 times daily and bifidobacterium triple viable capsules 420 mg/time, 3 times daily for 30 days. Changes of intestinal flora in the feces, serum tumor necrosis factor alpha（TNF-α）, interleukin 6（IL-6）, plasma endotoxin, alanine transfer enzymes（ALT）, aspartate amino transfer（AST）, total bilirubin（TBil）, total cholesterol（TC） and triglyceride（TG） were compared before and after treatment. Homeostasis model was used to assess the insulin resistance and the correlation between intestinal flora and plasma endotoxin level was analyzed. Results Before treatment, compared with healthy controls, the number of bifidobacteria and lactobacillus in patients with NAFLD decreased significantly（t =-2.320,-2.875; P = 0.022, 0.002）, and the number of staphylococcus and intestinal bacteria increased significantly（t = 4.352, 3.435; P = 0.000, 0.001）, there were no significant changes in the numbers of enterococcus and bacteroides（t = 0.834, 1.459; P = 0.401, 0.173）. After treatment, the numbers of bifidobacteria and lactobacillus increased both in group A and group B, and the differences were statistically significant（t = 2.455, 2.526; P
出处
《中国肝脏病杂志（电子版）》
CAS
2016年第3期87-92,共6页
Chinese Journal of Liver Diseases：Electronic Version
关键词
脂肪肝
非酒精性
肠道菌群
微生态制剂
Fatty liver
non-alcoholic
Intestinal flora
Micro ecological preparation
