益生菌对肝硬化患者肠道菌群及外周血T细胞亚群的影响

Effects of probiotics for intestinal flora and T lymphocyte subsets in patients with liver cirrhosis

目的:观察肝硬化患者口服三联活菌和二联活菌前后肠道菌群、血浆内毒素及细胞免疫功能(T细胞亚群)的变化。方法:选择肠道菌群中具有代表性的细菌共7种进行培养和计数。50例肝硬化患者随机分成两组,分别予三联活菌及二联活菌治疗,疗程14 d。另选择20例健康志愿者作为对照组,测定治疗前后肠道菌群菌落计数及T细胞亚群。结果:与正常对照相比,肝硬化组患者存在不同程度的肠道菌群失调,主要表现为双歧杆菌减少,正常组和肝硬化组的菌落数分别为(10.04±0.78)lg CFU.g-1和(9.48±1.13)lg CFU.g-1(P<0.05)。治疗后,三联活菌组双歧杆菌由(9.46±1.09)lg CFU.g-1增至(10.30±1.11)lg CFU.g-1;二联活菌组由(9.81±0.62)lg CFU.g-1增至(10.44±1.08)lg CFU.g-1,数量均显著增加(P<0.05)。二联活菌组治疗后外周血中CD4+淋巴细胞分数由(0.33±0.05)增至(0.36±0.06)(P<0.05)。结论:肝硬化患者存在肠道菌群失调,益生菌制剂可有效改善肝硬化患者肠道菌群失调,二联活菌制剂具有一定的免疫调节作用。

Objective： To assess the effects of probiotics for intestinal flora, serum endotoxin and immune functions in patients with liver cirrhosis. Methods： 7 intestinal floras were cultured and the colony forming units were counted. 50 patients with liver cirrhosis （treatment group） and 20 healthy volunteers （control group） were randomized to receive tri-probiotics capsules containing Bifidobacterium, Lactobacillus acidophilus and Enterococcus, or bi-probiotics capsules containing Bacillus subtilis and Enterococcus faecium for 14 days. Fecal flora and T lymphocyte subsets were measured before and after the treatment. Results： Compared with the control group, patients with liver cirrhosis experienced certain intestinal flora imbalances, i.e., a decrease in the count of Bifidobacterium （10.04±0. 78） lg CFU·g^-1 vs. （9.48±1.13） lg CFU·g^-1（ P 〈0. 05）. The tri-probiotics increased Bifidobacterium count from（9.46±1.09） lg CFU·g^-1 to （ 10.30 ±1.11） lg CFU·g^-1, and so did the bi-probiotics from（9.81 ±0.62） lg CFU·g^-1 to （10.44±1.08） lg CFU·g^-1 ,respectively, post the treatment（ P 〈 0.05）, The bi-probiotics increased the number of CD4 positive T lymphocytes from （0.33± 0.05） to （0.36±0.06） （ P 〈 0.05）. Conclusion： Probiotics significantly balanced the flora count for patients with liver cirrhosis. The bi-probiotics improved the immune function