益生菌辅治对妊娠期肝内胆汁淤积症患者实验室指标及肠道菌群结构的影响

Effect of Adjuvant Treatment with Probiotics on Laboratory Indexes and Intestinal Flora Structure in Patients with Intrahepatic Cholestasis of Pregnancy

目的:探究益生菌辅治对妊娠期肝内胆汁淤积症(ICP)患者实验室指标及肠道菌群结构的影响.方法:选取我院收治的72例妊娠期肝内胆汁淤积症患者,按随机数字表法分成两组,各36例,对照组单用熊去氧胆酸片(8~10 mg/kg,bid)治疗,观察组在对照组基础上加用双歧杆菌三联活菌胶囊(0.42 g,bid)治疗.两组疗程均为2周.比较两组实验室生化指标以及肠道菌群结构的变化情况.结果:两组总胆红素(TBIL)、直接胆红素(DBIL)、总胆汁酸(TBA)、甘胆酸(CG)、血氨(BA)均较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05);两组肿瘤坏死因子(TNF-α)、白细胞介素(IL)-6表达水平较治疗前下降,且观察组低于对照组,差异有统计学意义(P<0.05);两组转化生长因子(TGF)-β1表达水平较治疗前差异无统计学意义(P>0.05);观察组双歧杆菌、乳酸杆菌、双歧杆菌/大肠杆菌比值均较治疗前呈明显升高,大肠杆菌较治疗前下降,且观察组改善程度更大,差异有统计学意义(P<0.05).结论:益生菌辅治有利于恢复ICP患者肠道菌群的平衡,改善肝功能,平衡免疫功能.

Objective:To explore the effect of the adjuvant treatment with probiotics on laboratory indicators and intestinal flora structure in patients with intrahepatic cholestasis of pregnancy(ICP).Methods:72 patients with intrahepatic cholestasis of pregnancy admitted to our hospital were selected and randomly divided into two groups,36 cases each.The patients in the control group were treated with ursodeoxycholic acid tablets alone(8~10 mg/kg,bid),and the patients in the observation group were treated with Bifidobacterium triple live capsules(0.42 g,bid)on the basis of the control group.The course of treatment in the two groups was 2 weeks.The biochemical indexes and the changes in the structure of the intestinal flora were compared between the two groups.Results:The levels of total bilirubin(TBIL),direct bilirubin(DBIL),total bile acid(TBA),glycocholic acid(CG)and blood ammonia(BA)after treatment were lower than those before treatment in the two groups,and the levels in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).The expression levels of tumor necrosis factor(TNF-α)and interleukin(IL)-6 after treatment were lower than those before treatment in the two groups,and the expression levels in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in the expression level of transforming growth factor(TGF)-β1 between the two groups(P>0.05).The number of Bifidobacterium,Lactobacillus and the ratio of Bifidobacterium to Escherichia coli after treatment in the observation group were significantly higher than those before treatment,while the number of Escherichia coli was lower than that before treatment,and the degree of changes in the observation group was greater than that in the control group,with statistically significant differences(P<0.05).Conclusion:Probiotics help to restore the balance of intestinal flora in ICP patients,improve liver functions and balance immune function.