枯草杆菌二联活菌肠溶胶囊联合多烯磷脂酰胆碱治疗NAFLD疗效及对血清Pygo2、HMGB1和HIF-1α的影响

Efficacy of bacillus subtilis duplex and polyene phosphatidylcholine combination in treatments of patients with nonalcoholic fatty liver diseases

目的探讨枯草杆菌二联活菌联合多烯磷脂酰胆碱治疗非酒精性脂肪性肝病(NAFLD)患者的疗效及其对血清人尾肢同源蛋白2(Pygo2)、高迁移率族蛋白B1(HMGB1)和人缺氧诱导因子1α(HIF-1α)的影响。方法2015年6月~2016年6月我院诊治的78例NAFLD患者被随机分为观察组39例和对照组39例,分别给予多烯磷脂酰胆碱和枯草杆菌二联活菌或单纯多烯磷脂酰胆碱治疗,观察3 m。采用ELISA法检测血清Pygo2、HMGB1和HIF-1α水平。结果在治疗3 m末,观察组血清TG、TC、LDL-C和HDL-C水平分别为(1.2±0.2)mmol/L、(4.1±0.2)mmol/L、(3.1±0.1)mmol/L和(3.9±0.3)mmol/L,与对照组的(1.6±0.3)mmol/L、(5.1±0.3)mmol/L、(3.5±0.2)mmol/L和(3.2±0.2)mmol/L比,存在显著性差异(P<0.05);血清MDA和SOD水平分别为(4.4±0.7)μmol/L和(168.9±15.7)U/L,与对照组的(5.4±0.8)μmol/L和(154.4±15.3)U/L比,存在显著性差异(P<0.05);血清Pygo2、HMGB1和HIF-1α水平分别为(41.5±3.4)μg/L、(15.7±4.6)μg/L和(24.5±4.6)μg/L,明显低于对照组[(48.2±3.7)μg/L、(26.4±5.1)μg/L和(32.6±4.7)μg/L,P<0.05];脂肪肝分度为正常、轻度、中度和重度的比例分别为56.4%、35.9%、5.1%和2.6%,显著优于对照组(分别为10.3%、30.8%、41.0%和17.9%,P<0.05)。结论枯草杆菌二联活菌联合多烯磷脂酰胆碱治疗NAFLD患者效果显著,可有效改善血脂水平,减轻氧化应激状态,具有良好的临床应用价值。

Objective To investigate the efficacy of bacillus subtilis duplex and polyene phosphatidylcholine combination in the treatment of patients with nonalcoholic fatty liver diseases(NAFLD)and its effects on serum people end limb homologous protein 2(Pygo2),high mobility group protein B1(HMGB1)and hypoxia inducible factor-1α(HIF-1α)levels.Methods 78 patients with NAFLD admitted to our hospital between June 2015 and June 2016 were divided randomly into observation(n=39)and control group(n=39),and received bacillus subtilis duplex and polyene phosphatidylcholine combination or the latter alone for three months.Serum Pygo2,HMGB1 and HIF-1αwere detected by using ELISA.Results At the end of three month treatment,serum levels of TG,TC,LDL-C and HDL-C in the observation group were(1.2±0.2)mmol/L,(4.1±0.2)mmol/L,(3.1±0.1)mmol/L and(3.9±0.3)mmol/L,significantly different compared to[(1.6±0.3)mmol/L,(5.1±0.3)mmol/L,(3.5±0.2)mmol/L and(3.2±0.2)mmol/L in the control,P<0.05];serum levels of MDA and SOD were(4.4±0.7)μmol/L and(168.9±15.7)U/L,significantly different compared to[(5.4±0.8)μmol/L and(154.4±15.3)U/L in the control,P<0.05];serum levels of Pygo2,HMGB1 and HIF-1 alpha were(41.5±3.4)μg/L,(15.7±4.6)μg/L and(24.5±4.6)μg/L,respectively,significantly lower than[(48.2±3.7)μg/L,(26.4±5.1)μg/L and(32.6±4.7)μg/L in the control,P<0.05];the percentages of normal liver,and mild,moderate and severe fatty liver were 56.4%,and 35.9%,5.1%and 2.6%,respectively,significantly better than(10.3%,and 30.8%,41.0%and 17.9%,P<0.05)in the control.Conclusion The application of bacillus subtilis duplex and polyene phosphatidylcholine combination in the treatment of patients with NAFLD is clinically efficient,which might effectively improve blood lipid imbalance,inhibit oxidative stress,and reduce serum Pygo2,HMGB1 and HIF-1αlevels.