益生菌改善维持性血液透析患者微炎症状态的临床观察

Clinical effect of probiotics on micro-inflammatory state in patients undergoing maintenance hemodialysis

目的观察益生菌改善维持性血液透析患者微炎症状态的临床效果。方法选取2016年10~12月在武汉市第五医院血液净化中心维持性血液透析患者96例,采用随机数表法将患者分为益生菌组和对照组,每组48例。益生菌组予基础治疗+益生菌颗粒,对照组予基础治疗,治疗时间2个月,治疗前后分别检测并比较两组患者的血清C反应蛋白(CRP)、白细胞介素6(IL-6)及α肿瘤坏死因子(TNF-α)水平。结果 96例维持性血液透析患者的平均CRP、IL-6、TNF-α分别为(13.74±2.12)mg/L、(113.17±25.48)pg/mL、(127.87±32.09)pg/mL,微炎症指标均处于升高状态;益生菌组患者治疗前的CRP、IL-6、TNF-α分别为(13.28±2.19)mg/L、(113.52±26.33)pg/mL、(127.03±32.81)pg/mL,治疗后分别为(10.43±1.05)mg/L、(92.34±20.71)pg/mL、(90.51±22.46)pg/mL,治疗后CRP、IL-6、TNF-α较治疗前下降,且差异具有统计学意义(P<0.05);对照组患者治疗后CRP、IL-6、TNF-α分别为(13.92±1.13)mg/L、(114.28±24.53)pg/mL、(127.19±29.37)pg/mL,治疗后益生菌组CRP、IL-6、TNF-α明显低于对照组,且差异均有统计学意义(P<0.05)。结论维持性血液透析患者体内存在微炎症状态,补充益生菌治疗可以改善维持性血液透析患者的微炎症状态。

Objective To observe the clinical effect of probiotics on micro-inflammatory state in patients undergoing maintenance hemodialysis（MHD）. Methods A total of 96 patients undergoing MHD in the Blood Purification Center in Fifth Hospital of Wuhan from October 2016 to December 2016 were selected. Accroding to the random number table, they were divided into probiotics group and control group, with 48 patients in each group. The probiotics group was given basic treatment combined with probiotic granule, and the control group received basic treatment only, with the treatment time for 2 months. The levels of serum C-reactive protein（CRP）, interleukin-6（IL-6） and tumor necrosis factor α（TNF-α） were measured and compared before and after treatment between the two groups.Results Among the 96 MHD patients, the mean levels of CRP, IL-6 and TNF-α were（13.74±2.12） mg/L,（113.17±25.48） pg/m L and（127.87±32.09） pg/m L, respectively, and the micro-inflammatory indicators were significantly elevated. The levels of CRP, IL-6 and TNF-α were（13.28±2.19） mg/L,（113.52±26.33） pg/m L and（127.03±32.81） pg/m L before treatment in probiotics group, respectively, which were significantly higher than（10.43±1.05） mg/L,（92.34±20.71）pg/m L and（90.51±22.46） pg/m L after treatment（P〈0.05）. The levels of CRP, IL-6 and TNF-α were（13.92±1.13） mg/L,（114.28±24.53） pg/m L and（127.19±29.37） pg/m L after treatment in the control group, respectively, which were significnatly higher than those in probiotics group（P〈0.05）. Conclusion MHD patients have micro-inflammatory state, and the probiotics therapy can improve the microinflammation status of MHD patients.