益生菌对宫颈癌放疗患者肠道菌群、肠道功能及T淋巴细胞水平的影响

Effects of probiotics on intestinal flora,intestinal function and T lymphocyte level in patients with cervical cancer after radiotherapy

目的探讨益生菌对宫颈癌放疗患者肠道菌群、肠道功能及T淋巴细胞水平的影响。方法选取郑州大学第二附属医院2020年9月至2022年2月行盆腔放疗的宫颈癌患者92例,采用随机数字表法分为对照组、试验组各46例。试验组患者放疗期间服用益生菌,对照组患者放疗期间未服用益生菌。比较两组放疗前后肠道菌群数量、D-乳酸、二胺氧化酶(DAO)、T淋巴细胞亚群水平,测定两组患者尿乳果糖(L)、甘露醇(M)浓度并计算L/M。结果放疗10次、放疗15次、放疗20次、放疗后,试验组大肠杆菌数量、肠球菌数量均低于对照组(F=128.60、224.99,均P<0.05),双歧杆菌数量、乳酸杆菌数量均高于对照组(F=2065.46、948.23,均P<0.05)。放疗10次、放疗15次、放疗20次、放疗后,试验组血浆D-乳酸分别为(9.34±1.63)μg/L、(9.15±1.36)μg/L、(8.68±1.06)μg/L、(8.05±0.82)μg/L,血浆DAO分别为(86.34±20.25)μg/L、(84.28±17.45)μg/L、(80.40±13.35)μg/L、(76.85±10.87)μg/L,尿L/M分别为(1.84±0.16)、(1.55±0.12)、(1.26±0.09)、(0.98±0.06),均低于对照组(F=121.60、31.73、417.84,均P<0.05)。放疗10次、放疗15次、放疗20次、放疗后,试验组CD4^(+)分别为(39.80±4.90)%、(40.92±5.30)%、(42.52±6.14)%、(43.83±6.55)%,CD4^(+)/CD8^(+)分别为(1.52±0.25)、(1.63±0.22)、(1.71±0.39)、(1.83±0.22),均高于对照组(F=58.69、31.07,均P<0.05)。结论宫颈癌放疗患者给予益生菌治疗可以改善患者肠道菌群状态和肠道屏障功能,同时可提高患者细胞免疫功能。

Objective To investigate the effects of probiotics on intestinal flora,intestinal function,and T lymphocyte level in patients with cervical cancer after radiotherapy.Methods A total of 92 patients with cervical cancer who underwent pelvic radiotherapy in The Second Affiliated Hospital of Zhengzhou University from September 2020 to February 2022 were included in this study.They were randomly divided into control and experimental groups(n=46/group).The patients in the experimental group took probiotics during radiotherapy,while the patients in the control group did not take probiotics during radiotherapy.The amount of intestinal flora,D-lactic acid,diamine oxidase,and T lymphocyte subset levels pre-and post-radiotherapy were compared between the two groups.Urinary lactulose(L)and mannitol(M)concentrations were determined in each group.Urinary excretion ratios of L to M were calculated.Results After 10,15,and 20 times of radiotherapy and after all radiotherapies,the amount of Escherichia coli and Enterococcus in the experimental group was significantly lower than that in the control group(F=128.60,224.99,all P<0.05).The amount of Bifidobacteria and Lactobacilli in the experimental group was significantly higher than that in the control group(F=2065.46,948.23,both P<0.05).After 10,15,and 20 times of radiotherapy and after all radiotherapies,plasma D-lactic acid level in the experimental group was(9.34±1.63)μg/L,(9.15±1.36)μg/L,(8.68±1.06)μg/L,and(8.05±0.82)μg/L,respectively.After 10,15,and 20 times of radiotherapy and after all radiotherapies,plasma diamine oxidase level in the experimental group was(86.34±20.25)μg/L,(84.28±17.45)μg/L,(80.40±13.35)μg/L,and(76.85±10.87)μg/L,respectively,and urinary excretion ratio of L to M in the experimental group was(1.84±0.16),(1.55±0.12),(1.26±0.09),(0.98±0.06),respectively,all of which were significantly lower than those in the control group(F=121.60,31.73,417.84,all P<0.05).After 10,15,and 20 times of radiotherapy and after all radiotherapies,CD4^(+)level in the experimental group was(39.80±4.90)%,(40.92±5.30)%,(42.52±6.14)%,(43.83±6.55)%,respectively,CD4^(+)/CD8^(+)was(1.52±0.25),(1.63±0.22),(1.71±0.39),(1.83±0.22),respectively,all of which were significantly higher than those in the control group(F=58.69,31.07,all P<0.05).Conclusion Probiotics can improve the status of intestinal flora and intestinal barrier function in patients with cervical cancer after radiotherapy,and simultaneously improve the cellular immune function of patients.