肠道益生菌对老年非酒精性脂肪性肝病患者肝脏脂肪含量和认知功能的影响

Effects of intestinal probiotics on liver fat content and cognitive function in elderly patients with nonalcoholic fatty liver disease

目的探讨肠道益生菌对老年非酒精性脂肪性肝病(NAFLD)患者的作用及临床效果。方法用抽签法将86例老年NAFLD患者分为观察组和对照组各43例。对照组患者予以常规治疗,观察组患者予以常规治疗+肠道益生菌治疗。比较两组患者治疗前后肠道菌群[双歧杆菌、大肠杆菌、肠道微生物定值抗力(B/E)]、肠道屏障功能[内毒素、二胺氧化酶(DAO)]、肝功能[门冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、谷氨酰转移酶(GGT)]、肝脏超声衰减系数、肝脏脂肪含量(LFC)、认知功能[蒙特利尔认知评估量表(MoCA)]水平。结果治疗3个月后,观察组双歧杆菌数、大肠杆菌数、B/E高于治疗前和对照组(P均<0.05),血清内毒素、DAO水平低于治疗前和对照组(P均<0.05)。治疗3个月后,两组血清AST、ALT、GGT水平以及超声衰减系数、LFC均较治疗前降低,且观察组低于对照组(P均<0.05);两组MoCA评分均较治疗前升高,且观察组高于对照组(P均<0.05)。结论老年NAFLD患者口服肠道益生菌有助于平衡肠道菌群和改善肠道屏障功能,可减少肝脏脂肪沉积,促进肝功能恢复,并有效提高认知功能。

Objective To investigate the effects and clinical effects of intestinal probiotics on elderly patients with nonalcoholic fatty liver disease(NAFLD).Methods A total of 86 elderly patients with NAFLD were divided into observation group and control group by lottery,with 43 cases in each group.The patients in control group were given routine treatment while the patients in observation group were treated with routine treatment+intestinal probiotics.The intestinal flora[Bifidobacteria,Escherichia coli,intestinal microbial resistance(B/E)],intestinal barrier function[endotoxin,diamine oxidase(DAO)],liver function[aspartate aminotransferase(AST),alanine aminotransferase(ALT),glutamyltransferase(GGT)],ultrasound attenuation coefficient,liver fat content(LFC)and cognitive function[Montreal Cognitive Assessment Scale(MoCA)]were compared between the two groups before and after treatment.Results After 3 months of treatment,the number of Bifidobacteria,the number of Escherichia coli and B/E in observation group were significantly higher than those before treatment and those in control group(P<0.05),and the levels of serum endotoxin and DAO were significantly lower than those before treatment and those in control group(P<0.05).After 3 months of treatment,the levels of serum AST,ALT and GGT,ultrasound attenuation coefficient and LFC in the two groups were lower than those before treatment,and the indexes in observation group were lower than those in control group(P<0.05).The MoCA scores in the two groups were higher than those before treatment,and the score in observation group was higher than that in control group(P<0.05).Conclusion Oral ntestinal probiotics in elderly patients with NAFLD can help improve balance of intestinal flora and improvement of intestinal barrier function,reduce liver fat deposition,promote liver function recovery,and effectively improve cognitive function.