益生菌对肝硬化自发性腹膜炎的预防及对肝功能的影响

The influence of probiotics on the liver function and prevention of spontaneous bacterial peritonitis in patients with liver cirrhosis

目的观察益生菌在肝硬化自发性腹膜炎患者中的预防效果及对肝功能的影响。方法选取福建省立医院南院2015年6月至2017年6月就诊治疗的60例肝硬化失代偿期患者为研究对象,随机平均分为对照组和益生菌组,每组30例。对照组患者采用常规保肝护肝利尿补充白蛋白治疗;益生菌组在对照组基础上加用金双歧口服,2.0g/次,3次/d,疗程3个月。比较两组患者治疗后6个月血浆内毒素(ET)、肿瘤坏死因子-α(TNF-α)、白介素6 (IL-6)、降钙素原(PCT)的水平以及肝功能指标、自发性腹膜炎(SBP)发生率和症状缓解时间的变化。结果治疗前两组患者ET、TNF-α、IL-6、PCT水平及肝功能指标比较差异无统计学意义(P<0.01)。治疗后益生菌组患者ET、TNF-α、IL-6、PCT水平明显低于对照组(P<0.01),肝功能指标也明显优于对照组(P<0.05)。两组患者SBP发生率相比差异有统计学意义(P<0.05),益生菌组患者发热缓解时间与腹部压痛缓解时间明显短于对照组(P<0.05)。结论益生菌可以有效预防肝硬化失代偿期患者自发性腹膜炎的发生,改善患者肝功能并缩短发病时各症状的缓解时间。

Objective To observe the effect of probiotics for prevention of spontaneous bacterial peritonitis（SBP）and on liver function in patients with liver cirrhosis.Methods Sixty patients with decompensated cirrhosis treated in Southern Area of Fujian Provincial Hospital from June 2015 to June 2017 were randomly divided into control group（30 cases）or probiotics group（30 cases）.The patients in control group were treated with conventional hepatoprotective drug,diuresis and albumin administration;The probiotics group were administrated Jin Shuangqi orally 2.0 g tid based on the conventional therapy.The course of treatment was3 months.The levels of plasma endotoxin（ET）,tumor necrosis factor alpha（TNF-α）,interleukin-6（IL-6）and serum procalcitonin（PCT）,the indexes of liver function,the incidence of SBP,and the time to the relief of symptoms were compared between the two groups six months after treatment.Results Before treatment,there were no significant differences between the two groups in the levels of ET,TNF-α,IL-6 and PCT and in the indexes of liver function（Ps〉0.05）.After treatment,the levels of ET,TNF-α,IL-6 and PCT were lower in the probiotics group than in the control group（Ps〈0.01）,and the indexes of liver function were significantly better in probiotics group than in control group（P〈0.05）.There was significant difference between the two groups in the incidence of SBP（P〈0.05）.The time to the relief of fever and that of abdominal tenderness in patients with SBP were shorter in probiotics group than in control group（P〈0.05）.Conclusion Probiotics can effectively prevent the occurrence of SBP in patients with decompensated cirrhosis,improve the liver function of patients and shorten the time to relief of symptoms.