酪酸梭菌活菌治疗对慢性乙型肝炎病人肠道菌群影响

EFFECT OF VIABLE CLOSTRIDIUM BUTYRICUM TREATMENT ON INTESTINAL FLORA IN PATIENTS WITH CHRONIC HEPATITIS B

目的探讨酪酸梭菌活菌治疗慢性乙型肝炎(CHB)病人的效果及其对肠道菌群的影响。方法选取2019—2020年青岛市第六人民医院的CHB病人53例和健康体检者28例。将CHB病人随机分为对照组27例和治疗组26例,对照组给予常规抗病毒及保肝治疗,治疗组在对照组基础上加用酪酸梭菌活菌治疗。对所有粪便样本DNA进行检测,利用LefSe等生物信息学软件分析菌群差异;检测CHB病人血清谷丙转氨酶(ALT)、谷草转氨酶(AST)和总胆红素(TBIL)水平。结果与健康人相比,CHB病人肠道菌群结构发生了改变,相对丰度差异排名前9的科水平物种中,CHB病人丰度高于健康人的有7个(W=947~1178,P<0.05),低于健康人的有2个(W=492、503,P<0.05)。治疗后,治疗组酪酸梭菌和双歧杆菌升高值明显高于对照组(H=19.893、11.219,P<0.05),血清ALT、AST和TBIL下降值明显高于对照组(W=2732~3054,P<0.05)。结论口服酪酸梭菌活菌胶囊能调节CHB病人肠道菌群的结构,促使肠道内益生菌丰度增加,改善肝功能,发挥辅助治疗作用。

Objective To investigate the efficacy of viable Clostridium butyricum in the treatment of patients with chro-nic hepatitis B(CHB)and its effect on intestinal flora.Methods A total of 53 patients with CHB and 28 healthy individuals who underwent physical examination in Qingdao Sixth People’s Hospital from 2019 to 2020 were enrolled.The patients with CHB were randomly divided into control group with 27 patients and treatment group with 26 patients,and the patients in the control group were given conventional antiviral and liver-protecting therapies,while those in the treatment group were given viable Clostridium butyricum bacteria in addition to the treatment in the control group.All fecal samples were tested for DNA,and bioinformatics software,such as LefSe,was used to analyze the differences in flora.The serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBIL)were measured for the patients with CHB.Results Compared with the healthy individuals,the patients with CHB had a significant change in the structure of intestinal flora,and as for the top nine species in terms of the difference in relative abundance at the family level,the CHB patients had a higher abundance of seven species(W=947-1178,P<0.05)and a lower abundance of two species(W=492,503;P<0.05).After treatment,compared with the control group,the treatment group had significantly greater increases in Clostridium butyricum and bifidobacteria(H=19.893,11.219;P<0.05)and significantly greater reductions in serum ALT,AST,and TBIL(W=2732-3054,P<0.05).Conclusion Oral administration of viable Clostridium butyricum capsules can regulate the structure of intestinal flora in patients with CHB,increase the abundance of probiotics in the intestine,and improve liver function,thereby playing the role of adjuvant therapy.