FMT改善非酒精性脂肪性肝病患者糖代谢的效果研究

Effect of FMT on Improving Glucose Metabolism in Patients with Non-Alcoholic Fatty Liver Disease

目的探讨粪便细菌移植在改善轻度非酒精性脂肪性肝病患者肝功能和糖代谢的影响。方法随机选择2020年1月—2021年2月福州市联勤保障部队第九〇〇医院仓山院区收治的轻度非酒精性肝病患者30例为研究对象,随机分为对照组和干预组,各15例,均在胃镜下留置鼻胃管,干预组每日粪便细菌溶液从胃管注入,对照组采取生理盐水对照,即每日生理盐水胃管注入。8周后观察对患者肝功能和糖代谢水平。结果干预组患者在干预后ALT为28.95(28.07,29.41)U/L、AST为14.60(14.00,15.16)U/L,TNF-α为(38.57±4.20)μg/mL,FPG为5.54(5.37,5.68)mmol/L、FINS为3.46(3.44,3.52)mIU/L、HOMA-IR为0.86(0.83,0.87),低于对照组ALT为52.66(52.34,53.01)U/L、AST为32.90(32.02,33.80)U/L,TNF-α为(52.36±5.59)μg/mL,FPG为7.49(7.40,7.58)mmol/L、FINS为5.72(5.10,6.35)mIU/L、HOMA-IR为1.87(1.72,1.12),差异有统计学意义(Z=-4.666、-4.666,t=7.635,Z=-4.666、-4.666、-4.666,P<0.001)。结论FMT对NAFLD进行肠道菌群调控可上调胰岛素受体水平、改善胰岛素抵抗、改善NAFLD患者肝功能水平及纠正糖代谢紊乱,恢复肝脏受损功能。

Objective To investigate the effect of fecal bacterial transplantation on improving liver function and glucose metabolism in patients with mild nonalcoholic fatty liver disease.Methods Thirty patients with mild non-alcoholic liver disease who were admitted to Cangshan Campus of the No.900 Hospital of Fuzhou Joint Logistics Support Force from January 2020 to February 2021 were randomly selected as the research objects.Randomly divided into the control group and the intervention group,15 cases in each group,all of them were given nasogastric tube indwelling under the gastroscope,the intervention group was injected with daily fecal bacterial solution from the gastric tube,and the control group was given normal saline control,that is,the daily normal saline was injected into the gastric tube.The liver function and glucose metabolism level of the patients were observed after 8 weeks.Results After the intervention,the ALT in the FMT group 28.95(28.07,29.41)U/L,the AST 14.60(14.00,15.16)U/L,the TNF-α(38.57±4.20)μg/mL,the FPG 5.54(5.37,5.68)mmol/L,the FINS 3.46(3.44,3.52)mIU/L,and HOMA-IR 0.86(0.83,0.87),lower than the control group ALT 52.66(52.34,53.01)U/L,AST 32.90(32.02,33.80)U/L,TNF-α(52.36±5.59)μg/mL,FPG 7.49(7.40,7.58)mmol/L,FINS 5.72(5.10,6.35)mIU/L,and HOMA-IR 1.87(1.72,1.12),the difference was statistically significant(Z=-4.666,-4.666,t=7.635,Z=-4.666,-4.666,-4.666,P<0.001).Conclusion The regulation of intestinal flora by FMT in NAFLD can up-regulate insulin receptor level,improve insulin resistance,improve liver function level in NAFLD patients,correct glucose metabolism disorder,and restore damaged liver function.