复方嗜酸乳杆菌联合庆大霉素治疗肝硬化的临床疗效及其对患者免疫功能的影响

Clinical efficacy of compound lactobacillus acidophilus combined with gentamicin in the treatment of liver cirrhosis and the impact on immune status of patients

目的探讨复方嗜酸乳杆菌联合庆大霉素治疗肝硬化的临床疗效及其对患者免疫功能的影响。方法选取凉山州第一人民医院2015年1月—2016年1月收治的肝硬化患者60例,随机分为对照组和观察组,各30例。对照组患者单纯采用庆大霉素治疗,观察组患者在对照组基础上采用复方嗜酸乳杆菌治疗。比较两组患者治疗前后血浆内毒素水平、免疫细胞因子[白介素6(IL-6)、肿瘤坏死因子α(TNF-α)、血小板活化因子(PAF)、CD_4^+细胞分数、CD_8^+细胞分数、CD_4^+/CD_8^+细胞比值]及肠道菌群。结果治疗前,两组患者内毒素、IL-6、TNF-α、PAF、CD_4^+细胞分数、CD_8^+细胞分数和CD_4^+/CD_8^+细胞比值比较,差异无统计学意义(P>0.05);治疗后,观察组患者内毒素、IL-6、TNF-α、PAF、CD_8^+细胞分数低于对照组,CD_4^+细胞分数、CD_4^+/CD_8^+细胞比值高于对照组(P<0.05)。两组患者治疗后内毒素、IL-6、TNF-α、PAF、CD_8^+细胞分数低于治疗前,CD_4^+细胞分数、CD_4^+/CD_8^+细胞比值高于治疗前(P<0.05)。治疗前,两组患者肠杆菌、葡萄球菌、肠球菌、酵母菌、拟杆菌、消化球菌、双歧杆菌、乳杆菌、真杆菌含量比较,差异无统计学意义(P>0.05);治疗后,观察组患者双歧杆菌和乳杆菌含量高于对照组(P<0.05)。治疗后,观察组患者肠杆菌、葡萄球菌、拟杆菌、消化球菌、双歧杆菌、乳杆菌含量高于治疗前,对照组患者肠杆菌、双歧杆菌和真杆菌含量高于治疗前(P<0.05)。结论复方嗜酸乳杆菌联合庆大霉素治疗肝硬化的临床疗效确切,其可有效改善患者的免疫功能,增强机体免疫力。

Objective To investigate the clinical efficacy of compound Lactobacillus acidophilus combined with gentamicin in the treatment of liver cirrhosis and the impact on immune status of patients.Methods A total of 60 cases of patients with liver cirrhosis were selected from January 2015 to January 2016 in Liangshan First People＇s Hospital,which were randomly divided into control group and observation group,30 cases in each group.The control group was given gentamicin alone,and the observation group was given compound lactobacillus acidophilus based on control group.The plasma endotoxin levels,immune cell factors（IL-6,TNF-α,PAF,CD_4^＋ cell fraction,CD_8^＋ cell fraction,CD_4^＋/CD_8^＋ cell ratio）and the intestinal flora before and after treatment were compared between the two groups.Results Before treatment,there were no significant differences of plasma endotoxin levels,IL-6,TNF-α,PAF,CD_4^＋ cell fraction,CD_8^＋ cell fraction or CD_4^＋/CD_8^＋ cell ratio between the two groups（P〈0.05）;after treatment,the observation group of plasma endotoxin levels,IL-6,TNF-α,PAF,CD_8^＋ cell fraction were lower than control group,CD_4^＋ cell fraction,CD_4^＋/CD_8^＋ cell ratio were higher than control group（P〈0.05）;after treatment,both groups of plasma endotoxin levels,IL-6,TNF-α,PAF,CD_8^＋ cell fraction were lower than prior treatment,CD_4^＋ cell fraction,CD_4^＋/CD_8^＋ cell ratio were higher than prior treatment（P〈0.05）.Before treatment,no significant differences of Enterobacteriaceae,Staphylococcus,Enterococcus,Yeast,Bacteroides,Peptococcus,Bifidobacterium,Lactobacillus or Eubacterium was found between the two groups（P〈0.05）;after treatment,the observation group of the contents of Bifidobacteria and Lactobacillus were higher than control group（P〈0.05）.After treatment,the levels of Enterobacteriaceae,Staphylococcus,Bacteroides,Peptococcus,Bifidobacteria and Lactobacillus in the observation group were higher than prior treatment（P〈0.05）,the levels of Enterobacteriaceae,Bifidobacteria and Eubacterium in control group were higher than prior treatment（P〈0.05）.Conclusion Compound lactobacillus acidophilus combined with gentamicin have an exactly clinical effect in the treatment of liver cirrhosis,it can effectively improve the immune status of patients,and enhance immunity.