双歧杆菌对慢性阻塞性肺疾病急性加重期患者肠道菌群和胃、肠黏膜屏障功能及免疫功能的影响

Effects of Bifidobacterium on gut microbiota, gastrointestinal mucosal barrier function and immune function in patients with acute exacerbation of chronic obstructive pulmonary disease

目的探索双歧杆菌对慢性阻塞性肺疾病急性加重期(AECOPD)患者肠道菌群和胃、肠黏膜屏障功能及免疫功能的影响,为该类患者的治疗提供参考。方法选取2021年5月至2023年5月我院收治的166例AECOPD患者作为研究对象,按照随机数字表分为治疗组(83例)和对照组(83例)。对照组患者进行常规治疗。治疗组患者在对照组基础上添加双歧杆菌治疗。收集患者的一般资料,包括年龄、性别、病程、体质量指数(BMI)。对两组患者的肠道菌群和胃、肠黏膜屏障功能及免疫功能进行检测和比较。结果治疗组患者临床总有效率高于对照组(95.18%vs 85.54%),不良反应发生率低于对照组(6.02%vs 4.82%),差异均有统计学意义(均P<0.05)。治疗前两组患者肠道菌群数量和胃、肠黏膜屏障功能及免疫功能水平差异均无统计学意义(均P>0.05)。治疗后两组患者肠道乳杆菌和双歧杆菌数量高于治疗前,肠杆菌和肠球菌数量低于治疗前,二氨氧化酶和D-乳酸水平低于治疗前,CD3^(+)细胞和CD4^(+)细胞水平高于治疗前,CD8^(+)细胞水平低于治疗前。治疗组患者肠道菌群改善情况和胃、肠黏膜屏障功能改善情况及免疫指标改善情况均优于对照组(均P<0.05)。结论双歧杆菌可显著改善AECOPD患者的肠道菌群和胃、肠黏膜屏障功能及免疫功能,值得临床推广。

Objective To explore the impacts of Bifidobacterium on gut microbiota, gastrointestinal mucosal barrier function and immune function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), providing a reference for the treatment. Methods A total of 166 AECOPD patients admitted to our hospital from May 2021 to May 2023 were enrolled and randomly divided into a treatment group (83 cases) and a control group (83 cases). Both groups received conventional treatment, while the treatment group was additionally given Bifidobacterium. General information of the patients, including age, gender, course of disease and body mass index (BMI), were collected. The gut microbiota, gastrointestinal mucosal barrier function, and immune function of the patients were detected and compared between groups. Results The treatment group had higher total clinical efficiency rate (95.18% vs 85.54%) and lower incidence of adverse reactions (6.02% vs 4.82%) than control group (all P<0.05). There were no statistically obvious differences in the level of gut microbiota, gastrointestinal mucosal barrier function, and immune function between the two groups before treatment (all P>0.05). After treatment, the counts of intestinal Lactobacillus and Bifidobacterium were higher, while those of Enterobacterium and Enterococcus were lower than before treatment;the levels of diamine oxidase and D-lactate were lower, those of CD3^(+) cells and CD4^(+) cells were higher, and that of CD8^(+) cells was lower than before treatment. The improvements of intestinal microbiota, gastrointestinal mucosal barrier function and immune indicators in the treatment group were better than those in the control group (all P<0.05). Conclusion Bifidobacterium can obviously improve the intestinal microbiota, gastrointestinal mucosal barrier function, and immune function of AECOPD patients, with good safety, and is worthy of clinical promotion.