三联活菌胶囊联合抗生素治疗对自发性细菌性腹膜炎患者炎性因子、肠粘膜屏障功能的影响
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摘要
目的:研究三联活菌胶囊联合抗生素治疗对自发性细菌性腹膜炎患者炎性因子、肠粘膜屏障功能的影响。方法:选择射洪县中医院2015年3月～2017年10月期间收治的肝硬化合并自发性细菌性腹膜炎患者,随机分为观察组和对照组。对照组给予常规对症治疗,观察组给予三联活菌胶囊联合常规对症治疗。治疗前及治疗后2周时,比较两组血清中炎性因子、肠粘膜屏障标志分子的含量以及粪便中肠道菌群的数目。结果:与治疗前比较,治疗后两组血清中PCT、CRP、sTREM-1、MCP-1、TNF-α、IFN-γ、DAO、D-乳酸、LPS、Occludin、ZO-1的含量以及粪便中肠杆菌、肠球菌的数目组内比较均显著低于治疗前(P<0.05),且观察组患者治疗后血清中PCT、CRP、sTREM-1、MCP-1、TNF-α、IFN-γ、DAO、D-乳酸、LPS、Occludin、ZO-1的含量以及粪便中肠杆菌、肠球菌的数目均显著低于对照组,粪便中双歧杆菌、乳酸杆菌、柔嫩梭菌的数目高于对照组(P<0.05)。结论:三联活菌胶囊联合抗生素治疗对自发性细菌性腹膜炎患者炎性因子的分泌具有抑制作用、对肠黏膜屏障功能具有改善作用。
Objective:To study the effect of Triple Viable Capsule combined with antibiotic therapy on the inflammatory factors and intestinal mucosal barrier function in patients with spontaneous bacterial peritonitis.Methods:Patients with cirrhosis combined with spontaneous bacterial peritonitis who were treated in Traditional Chinese Medicine Hospital of Shehong County between March 2015 and October 2017 were selected and randomly divided into the observation group who accepted Triple Viable Capsule combined with antibiotic therapy and the control group who accepted conventional symptomatic treatment.The levels of inflammatory factors and intestinal mucosal barrier markers in serum as well as the number of intestinal flora in feces were detected before treatment and 2 weeks after treatment.Results:Compared with those of same group before treatment,PCT,CRP,sTREM-1,MCP-1,TNF-α,IFN-γ,DAO,D-lactic acid,LPS,Occludin and ZO-1 levels in serum as well as the number of enterobacter and enterococcus in feces of both groups of patients were lower whereas the number of bifidobacterium,lactobacillus and clostridium leptum were higher after treatment,and PCT,CRP,sTREM-1,MCP-1,TNF-α,IFN-γ,DAO,D-lactic acid,LPS,Occludin and ZO-1 levels in serum as well as the number of enterobacter and enterococcus in feces of observation group after treatment were lower than those of control group whereas the number of bifidobacterium,lactobacillus and clostridium leptum were higher than those of control group.Conclusion:Triple Viable Capsule combined with antibiotic therapy can inhibit the secretion of inflammatory cytokines and improve the intestinal mucosal barrier function in patients with spontaneous bacterial peritonitis.
Objective:To study the effect of Triple Viable Capsule combined with antibiotic therapy on the inflammatory factors and intestinal mucosal barrier function in patients with spontaneous bacterial peritonitis.Methods:Patients with cirrhosis combined with spontaneous bacterial peritonitis who were treated in Traditional Chinese Medicine Hospital of Shehong County between March 2015 and October 2017 were selected and randomly divided into the observation group who accepted Triple Viable Capsule combined with antibiotic therapy and the control group who accepted conventional symptomatic treatment.The levels of inflammatory factors and intestinal mucosal barrier markers in serum as well as the number of intestinal flora in feces were detected before treatment and 2 weeks after treatment.Results:Compared with those of same group before treatment,PCT,CRP,sTREM-1,MCP-1,TNF-α,IFN-γ,DAO,D-lactic acid,LPS,Occludin and ZO-1 levels in serum as well as the number of enterobacter and enterococcus in feces of both groups of patients were lower whereas the number of bifidobacterium,lactobacillus and clostridium leptum were higher after treatment,and PCT,CRP,sTREM-1,MCP-1,TNF-α,IFN-γ,DAO,D-lactic acid,LPS,Occludin and ZO-1 levels in serum as well as the number of enterobacter and enterococcus in feces of observation group after treatment were lower than those of control group whereas the number of bifidobacterium,lactobacillus and clostridium leptum were higher than those of control group.Conclusion:Triple Viable Capsule combined with antibiotic therapy can inhibit the secretion of inflammatory cytokines and improve the intestinal mucosal barrier function in patients with spontaneous bacterial peritonitis.
引文
1 Fortune B,Cardenas A.Ascites,refractory ascites and hyponatremia in cirrhosis[J].Gastroenterol Rep,2017,5(2):104-112.
2 Wiest R,Lawson M,Geuking M.Pathological bacterial translocation in liver cirrhosis[J].J Hepatol,2014,60(1):197-209.
3 Gómez-Hurtado 1,Such J,Francés R.Microbiome and bacterial translocation in cirrhosis[J].Gastroenterol Hepatol,2016,39(10):687-696.
4 Fiore M,Maraolo AE,Leone S,et al.Spontaneous peritonitis in critically ill cirrhotic patients:a diagnostic algorithm for clinicians and future perspectives[J].Ther Clin Risk Manag,2017,16(13):1409-1414.
5 Lachar J,Bajaj JS.Changes in the Microbiome in Cirrhosis and Relationship to Complications:Hepatic Encephalopathy,Spontaneous Bacterial Peritonitis,and Sepsis[J].Semin Liver Dis,2016,36(4):327-330.
6 Betrapally NS,Gillevet PM,Bajaj JS.Gut microbiome and liver disease[J].Transl Res,2017,179:49-59.
7 Altamirano-Barrera A,Uribe M,Chávez-Tapia NC,et al.The role of the gut microbiota in the pathology and prevention of liver disease[J].J Nutr Biochem,2018,16(60):1-8.
8 Nikniaz Z,Nikniaz L,Bilan N,et al.Does probiotic supplementation affect pulmonary exacerbation and intestinal inflammation in cystic fibrosis:a systematic review of randomized clinical trials[J].World J Pediatr,2017,13(4):307-313.
9 Viramontes H?rner D,Avery A,Stow R.The Effects of Probiotics and Symbiotics on Risk Factors for Hepatic Encephalopathy:A Systematic Review[J].J Clin Gastroenterol,2017,51(4):312-323.
10 Van Biervliet S,Declercq D,Somerset S.Clinical effects of probiotics in cystic fibrosis patients:A systematic review[J].Clin Nutr ESPEN,2017,18:37-43.
11 Yang Y,Li L,Qu C,et al.Diagnostic Accuracy of Serum Procalcitonin for Spontaneous Bacterial Peritonitis Due to End-stage Liver Disease:A Meta-analysis[J].Medicine(Baltimore),2015,94(49):e2077.
12 Wu H,Chen L,Sun Y,et al.The role of serum procalcitonin and C-reactive protein levels in predicting spontaneous bacterial peritonitis in patients with advanced liver cirrhosis[J].Pak J Med Sci,2016,32(6):1484-1488.
13 Ichou L,Carbonell N,Rautou PE,et al.Ascitic fluid TREM-1for the diagnosis of spontaneous bacterial peritonitis[J].Gut,2016,65(3):536-538.
14 El-Toukhy N,Emam SM.Diagnostic and Prognostic Values of Monocyte Chemotactic Protein-1in Ascitic Fluid of Patients with Spontaneous Bacterial Peritonitis[J].Egypt J Immunol,2016,23(2):17-27.
15 Nieto JC,Sánchez E,Romero C,et al.Impaired innate immune response of leukocytes from ascitic fluid of patients with spontaneousbacterial peritonitis[J].J Leukoc Biol,2015,98(5):819-825.
16 Heshmati E,Shirpoor A,Kheradmand F,et al.Chronic ethanol increases calcium/calmodulin-dependent protein kinaseIIδgene expression and decreases monoamine oxidase amount in rat heart muscles:Rescue effect of Zingiber officinale(ginger)extract[J].Anatol J Cardiol,2018,19(1):19-26.
17 Li X,Chen L,Lin H,et al.Efficacy of Poly(D,L-Lactic Acidco-Glycolic acid)-Poly(Ethylene Glycol)-Poly(D,L-Lactic Acidco-Glycolic Acid)Thermogel As a Barrier to Prevent Spinal Epidural Fibrosis in a Postlaminectomy Rat Model[J].Clin Spine Surg,2017,30(3):E283-E290.
18 de Souza Xavier Costa N,Ribeiro Júnior G,Dos Santos Alemany AA,et al.Early and late pulmonary effects of nebulized LPS in mice:An acute lung injury model[J].PLoS One,2017,12(9):e0185474.
19 Steelant B,FarréR,Wawrzyniak P,et al.Impaired barrier function in patients with house dust mite-induced allergic rhinitis is accompanied by decreased occludin and zonula occludens-1expression[J].J Allergy Clin Immunol,2016,137(4):1043-1053.
2 Wiest R,Lawson M,Geuking M.Pathological bacterial translocation in liver cirrhosis[J].J Hepatol,2014,60(1):197-209.
3 Gómez-Hurtado 1,Such J,Francés R.Microbiome and bacterial translocation in cirrhosis[J].Gastroenterol Hepatol,2016,39(10):687-696.
4 Fiore M,Maraolo AE,Leone S,et al.Spontaneous peritonitis in critically ill cirrhotic patients:a diagnostic algorithm for clinicians and future perspectives[J].Ther Clin Risk Manag,2017,16(13):1409-1414.
5 Lachar J,Bajaj JS.Changes in the Microbiome in Cirrhosis and Relationship to Complications:Hepatic Encephalopathy,Spontaneous Bacterial Peritonitis,and Sepsis[J].Semin Liver Dis,2016,36(4):327-330.
6 Betrapally NS,Gillevet PM,Bajaj JS.Gut microbiome and liver disease[J].Transl Res,2017,179:49-59.
7 Altamirano-Barrera A,Uribe M,Chávez-Tapia NC,et al.The role of the gut microbiota in the pathology and prevention of liver disease[J].J Nutr Biochem,2018,16(60):1-8.
8 Nikniaz Z,Nikniaz L,Bilan N,et al.Does probiotic supplementation affect pulmonary exacerbation and intestinal inflammation in cystic fibrosis:a systematic review of randomized clinical trials[J].World J Pediatr,2017,13(4):307-313.
9 Viramontes H?rner D,Avery A,Stow R.The Effects of Probiotics and Symbiotics on Risk Factors for Hepatic Encephalopathy:A Systematic Review[J].J Clin Gastroenterol,2017,51(4):312-323.
10 Van Biervliet S,Declercq D,Somerset S.Clinical effects of probiotics in cystic fibrosis patients:A systematic review[J].Clin Nutr ESPEN,2017,18:37-43.
11 Yang Y,Li L,Qu C,et al.Diagnostic Accuracy of Serum Procalcitonin for Spontaneous Bacterial Peritonitis Due to End-stage Liver Disease:A Meta-analysis[J].Medicine(Baltimore),2015,94(49):e2077.
12 Wu H,Chen L,Sun Y,et al.The role of serum procalcitonin and C-reactive protein levels in predicting spontaneous bacterial peritonitis in patients with advanced liver cirrhosis[J].Pak J Med Sci,2016,32(6):1484-1488.
13 Ichou L,Carbonell N,Rautou PE,et al.Ascitic fluid TREM-1for the diagnosis of spontaneous bacterial peritonitis[J].Gut,2016,65(3):536-538.
14 El-Toukhy N,Emam SM.Diagnostic and Prognostic Values of Monocyte Chemotactic Protein-1in Ascitic Fluid of Patients with Spontaneous Bacterial Peritonitis[J].Egypt J Immunol,2016,23(2):17-27.
15 Nieto JC,Sánchez E,Romero C,et al.Impaired innate immune response of leukocytes from ascitic fluid of patients with spontaneousbacterial peritonitis[J].J Leukoc Biol,2015,98(5):819-825.
16 Heshmati E,Shirpoor A,Kheradmand F,et al.Chronic ethanol increases calcium/calmodulin-dependent protein kinaseIIδgene expression and decreases monoamine oxidase amount in rat heart muscles:Rescue effect of Zingiber officinale(ginger)extract[J].Anatol J Cardiol,2018,19(1):19-26.
17 Li X,Chen L,Lin H,et al.Efficacy of Poly(D,L-Lactic Acidco-Glycolic acid)-Poly(Ethylene Glycol)-Poly(D,L-Lactic Acidco-Glycolic Acid)Thermogel As a Barrier to Prevent Spinal Epidural Fibrosis in a Postlaminectomy Rat Model[J].Clin Spine Surg,2017,30(3):E283-E290.
18 de Souza Xavier Costa N,Ribeiro Júnior G,Dos Santos Alemany AA,et al.Early and late pulmonary effects of nebulized LPS in mice:An acute lung injury model[J].PLoS One,2017,12(9):e0185474.
19 Steelant B,FarréR,Wawrzyniak P,et al.Impaired barrier function in patients with house dust mite-induced allergic rhinitis is accompanied by decreased occludin and zonula occludens-1expression[J].J Allergy Clin Immunol,2016,137(4):1043-1053.