摘要
目的通过比较酪酸梭菌用药前后NAFLD患者的生化指标、B超结果及肠道菌群构成等,评价酪酸梭菌对NAFLD的疗效及对肠道菌群的影响。方法选择在我院消化内科就诊的NAFLD患者100例,另选50名健康对照者,分别用16S rDNA高通量测序检测两组的肠道菌群含量。所有NAFLD患者随机分为两组,对照组予以低脂饮食+有氧运动(如存在转氨酶升高,予以双环醇1粒tid po),观察组在此基础上联用酪酸梭菌(2粒tid po),3个月后通过Illumina NovaSeq平台对样本粪便DNA进行测序,观察肠道菌群变化,同时复查腹部B超、血脂(TG、CHOL)、肝功能(ALT、AST)、炎症因子(IL-6、TNF-α)、肠屏障指标(血清内毒素、DAO、D-乳酸活性水平)等。结果NAFLD患者较健康人群的厚壁菌减少,肠杆菌增多;肠屏障指标血清内毒素、DAO、D-乳酸活性水平升高。用药后观察组肠道有益菌较治疗前增多。两组的内毒素、DAO、D-乳酸水平均较治疗前下降(P<0.05),观察组下降较对照组更明显,差异有统计学意义(P<0.05)。观察组的治疗有效率(86.0%)高于对照组(74.0%)。结论NAFLD患者肠道菌群较健康人群有改变,存在肠屏障损伤。联合酪酸梭菌治疗有助于改善NAFLD患者的肠屏障功能,改善肠道菌群结构,降低血脂水平,提高疗效。
Objective To evaluate the efficacy of Clostridium butyricum on NAFLD and its effect on intestinal flora.Methods 100 patients with NAFLD and 50 healthy controls were selected in our hospital to have their intestinal flora measured by 16S rDNA high-throughput sequencing.All patients with NAFLD were randomly divided into two groups:the control group was given low fat diet+aerobic exercise(1 capsule tid po of Dicyclomine was given if transaminases were elevated),while the observation group was given Clostridium butyricum(2 capsules tid po)in addition to this.After 3 months,the fecal DNA of the samples was sequenced through Illumina NovaSeq platform to observe the changes of intestinal flora.At the same time,abdominal B-ultrasound,blood lipid(TG,CHOL),liver function(ALT,AST),inflammatory factor(IL-6,TNF-α)and intestinal barrier indexes(serum endotoxin,DAO,D-lactic acid activity level)were examined again.Results Compared with healthy people,patients with NAFLD had less Firmicutes and more Enterobacteriaceae;the serum endotoxin,DAO,D-lactate activity levels of intestinal barrier indicators were increased.After treatment,the intestinal beneficial bacteria in the observation group increased compared with that before treatment.The levels of endotoxin,DAO and D-lactate in both groups decreased compared with those before treatment(P<0.05),and the decrease was more obvious in the observation group than in the control group,and the difference was statistically significant(P<0.05).The effectiveness rate of the observation group(86.0%)was higher than that of the control group(74.0%).Conclusion Patients with NAFLD have altered intestinal flora compared to healthy controls and have intestinal barrier injury.Combined Clostridium butyricum treatment helps to improve intestinal barrier function,improve intestinal flora composition,reduce blood lipid levels and improve outcomes in patients with NAFLD.
作者
颜美珠
安敏
高振军
YAN Meizhu;AN Min;GAO Zhenjun(Department of Gastroenterology,Zhongshan Hospital,Qingpu Branch,Fudan University,Shanghai 201700,China)
出处
《胃肠病学和肝病学杂志》
CAS
2023年第5期493-498,共6页
Chinese Journal of Gastroenterology and Hepatology
基金
上海市青浦区科技发展基金项目(QKY2019-09)
上海市青浦区卫生健康委员会人才培养项目(W2019-18)。
关键词
非酒精性脂肪性肝病
酪酸梭菌
肠道菌群
肠屏障功能
Non-alcoholic fatty liver disease
Clostridium butyricum
Intestinal flora
Intestinal barrier
