利福昔明对肝硬化腹腔积液患者炎症因子、肠道菌群的影响研究

A Study on the Effects of Rifaximin on Inflammatory Factors and Gut Microbiota in Patients With Liver Cirrhosis and Ascites

目的探讨利福昔明对肝硬化腹腔积液患者炎症因子、肠道菌群的影响。方法选择同济大学附属东方医院胶州医院消化内科2022年1月—2023年6月收治的112例肝硬化腹腔积液患者作为研究对象,随机分为对照组与观察组,各56例。对照组给予常规性治疗,观察组给予“常规性+利福昔明”治疗。比较2组患者炎症因子、肠道菌群情况。结果从炎症水平看,经治疗后观察组白细胞介素-21(interleukin-21,IL-21)、白细胞介素-22(interleukin-22,IL-22)及转化生长因子-β1(transforming growth factor-β1,TGF-β1)分别为(30.27±4.26)pg/mL、(31.22±4.18)pg/mL、(3.14±1.02)pg/mL,低于对照组的(41.02±4.85)pg/m L、(41.49±4.93)pg/m L、(4.86±1.57)pg/m L(P<0.05)。从肠道菌群看,治疗后观察组患者双歧杆菌、乳杆菌分别是(9.91±0.52)cfu/g、(7.92±0.33)cfu/g均高于对照组的(8.76±0.48)cfu/g、(7.16±0.28)cfu/g(P<0.05);治疗后观察组患者肠球菌、肠杆菌分别是(6.74±0.35)cfu/g、(7.45±0.46)cfu/g均低于对照组(7.44±0.41)cfu/g、(8.57±0.52)cfu/g(P<0.05)。从肝功能看,经治疗后2组患者的肝功能水平均得到显著性改善,其中观察组患者的改善效果优于对照组(P<0.05)。结论在肝硬化腹腔积液患者治疗中,基于常规性治疗的同时联合给予利福昔明治疗,可以有效控制患者的炎症水平,改善肠道菌群环境及提高肝功能水平,治疗效果显著,为肝硬化腹腔积液规范治疗相关标准制定提供了借鉴内容。

Objective To Explore the effects of rifaximin on inflammatory factors and gut microbiota in patients with liver cirrhosis ascites.Methods A total of 112 patients with liver cirrhosis and ascites admitted to the department of gastroenterology at Jiaozhou Hospital,Dongfang Hospital Affiliated to Tongji University from January 2022 to June 2023 were selected as the study subjects and randomly divided into a control group and an observation group,with 56 patients in each group.The control group received routine treatment,while the observation group received"routine+rifampicin"treatment.Compare the inflammatory factors and gut microbiota of two groups of patients.Results From the inflammatory level,after treatment,interleukin-21(IL-21)、interleukin-22(IL-22)and transforming growth factor-β1(TGF-β1)values of(30.27±4.26)pg/mL,(31.22±4.18)pg/mL,and(3.14±1.02)pg/mL were significantly lower than those of the control group(41.02±4.85)pg/mL,(41.49±4.93)pg/mL,and(4.86±1.57)pg/mL,respectively(P<0.05).From the perspective of gut microbiota,after treatment,the observation group of patients had significantly higher levels of bifidobacteria and lactobacilli at(9.91±0.52)cfu/g and(7.92±0.33)cfu/g,respectively,compared to the control group at(8.76±0.48)cfu/g and(7.16±0.28)cfu/g(P<0.05).After treatment,the observation group of patients had significantly lower levels of(6.74±0.35)cfu/g and(7.45±0.46)cfu/g,respectively,compared to the control group at(7.44±0.41)cfu/g and(8.57±0.52)cfu/g(P<0.05).From the perspective of liver function,after treatment,the liver function levels of both groups of patients were significantly improved,and the improvement effect of the observation group was significantly better than that of the control group(P<0.05).Conclusion In the treatment of patients with liver cirrhosis ascites,the combination of conventional treatment and rifaximin treatment can effectively control the patient′s inflammatory level,improve the intestinal microbiota environment,and enhance liver function.The treatment effect is significant,providing reference content for the formulation of standardized treatment standards for liver cirrhosis ascites.