双歧杆菌对慢性肾脏病3-4期患者微炎症及营养状态的影响

The effects of Bifidobacterium on micro-inflammatory and nutritional status of patients with stage 3 to stage 4 chronic kidney disease

目的探讨双歧杆菌乳杆菌三联活菌片对慢性肾脏病(CKD)3-4期患者微炎症及营养状态的作用。方法选择2018年6月—2021年6月本院肾病科门诊及住院的120例CKD 3-4期患者作研究对象,根据就诊顺序奇偶数将奇数者纳入观察组,偶数者纳入对照组,每组各60例。对照组接受常规治疗,观察组在此基础上加用双歧杆菌乳杆菌三联活菌片。比较两组治疗前后血浆生化指标和炎症因子水平。结果观察组和对照组分别有3例和5例失访,最终分别纳入57例和55例;治疗后,观察组血清铁(SI)、血清铁蛋白(SF)、血清转铁蛋白(TRF)、二氧化碳结合力(CO 2)、血浆血尿素氮(BUN)、血肌酐(SCr)、β2微球蛋白(β2-MG)、尿酸(UA)、甲状旁腺激素(PTH)、血胱抑素C(Cys-C)、超敏C反应蛋白(hs-CRP)、白细胞介素-8(IL-8)、干扰素(IFN)-γ水平与对照组比较,差异均无统计学意义(P>0.05);治疗后,观察组白细胞介素-6(IL-6)水平低于对照组(t=7.498,P<0.001),观察者肿瘤坏死因子(TNF)-α水平低于对照组(t=10.176,P<0.001),观察组血红蛋白(HB)水平高于对照组(t=-7.669,P<0.001),观察组白蛋白(ALB)水平高于对照组(t=-8.897,P<0.001),对照组IL-10水平高于对照组(t=-11.692,P<0.001)。结论双歧杆菌乳杆菌三联活菌片可改善CKD患者微炎症及营养状态,未来可能成为延缓ESRD(end-stage renal disease)进展的研究方向。

Objective To explore the effect of live combined Bifidobacterium and lactobacillus tablets onmicro-inflammatory and nutritional status in patients with stage 3 to stage 4 chronic kidney disease(CKD).Methods A total of 120 patients suffered from stage3-4CKD those were treated in the nephrology department of the Yunnan third people's hospital from June 2018 to June 2021 were employed as research subjects,the odd-numbered individuals were included in the experimental group(60cases)and the even-numbered individuals in the control group(60 cases)according to the odd-even order of visit.Patients in control group was treated with routine treatment,in the experimental group,live combined bifidobacterium and lactobacillus tablets were added based on this.Plasma biochemical indicators and inflammatory factors in the two groups were compared between and after treatment.Results There were 3 cases of the experimental groupand 5 cases of the control groupwere lost to follow up,finally 57 cases and 55 cases were in included in the study respectively.After treatment,there were not statistical difference between experimental group and control group in serum iron(SI),serum ferritin(SF),serum transferrin(TRF),carbon dioxide binding force(CO 2),blood urea nitrogen(BUN),serum creatinine(SCr),β2-microglobulin(β2-MG),uric acid(UA),parathyroid hormone(PTH),cystatin C(Cys-C),high sensitivity C-reactive protein(hs-CRP),interleukin(IL)-8,interferon(IFN)-γ(P>0.05).However,the interleukin(IL)-6 in the experimental group was lower than that in the control group(t=7.498,P<0.001);the tumor necrosis factor(TNF)-αin the experimental group was lower than those in the control(t=10.176,P<0.001);the haemoglobin(HB)in the experimental group was higher than that in the control group(t=-7.669,P<0.001);the albumin(ALB)in the experimental group was higher than that in the control group(t=-8.897,P<0.001);and the interleukin(IL)-10 in the experimental group was lower than that in the control group(t=-11.692,P<0.001).Conclusions Live combined bifidobacterium and lactobacillus tablets can improve micro-inflammatory and nutritional status in CKD patients,and may become a focus for delaying the progression of end-stage renal disease(ESRD)in the future.