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1.
目的探讨儿童迁延性腹泻患者肠道菌群和肠黏膜屏障功能的变化以及双歧杆菌三联活菌散的干预作用。方法选取儿科就诊迁延性腹泻患儿40例为观察组,予以双歧杆菌三联活菌散1.0g/次,3次/d,溶解于温水中口服,连用8周,检测观察组患儿治疗前后肠道菌群数量及肠黏膜屏障指标的变化。另选择同期在我院体检的正常儿童30例为对照组。结果观察组患儿治疗前双歧杆菌、乳杆菌的数量及B/E比值明显少于对照组,而大肠埃希菌数量明显多于对照组(P0.05)。治疗8周后,观察组患儿双歧杆菌、乳杆菌的数量及B/E比值较治疗前明显上升,大肠埃希菌数量较治疗前明显下降(P0.05);观察组患儿治疗前血清D-乳酸、PCT和DAO水平明显高于对照组(P0.05)。治疗8周后,血清D-乳酸、PCT和DAO水平较治疗前明显下降(P0.05)。结论儿童迁延性腹泻患者存在肠道菌群紊乱,引起肠黏膜屏障功能受损,肠黏膜的通透性异常。双歧杆菌三联活菌散治疗儿童迁延性腹泻患者可纠正肠道菌群紊乱,保护肠黏膜屏障功能,降低其通透性,达到治疗腹泻的目的。  相似文献   

2.
目的探讨双歧杆菌四联活菌片对重症脑卒中患者肠道菌群及肠黏膜屏障功能的影响。方法选择重庆市人民医院2017年1月至2017年11月收治的100例重症脑卒中患者,随机将入选患者分为治疗组和对照组各50例。治疗组在常规肠内营养(EN)治疗基础上联用双歧杆菌四联活菌片治疗,对照组给予常规EN治疗。比较两组患者治疗前后营养状况、肠道菌群数量和肠黏膜屏障功能。比较两组患者治疗后消化道并发症发生率。结果治疗前,两组患者营养状况、肠道菌群数量和肠黏膜屏障功能差异无统计学意义(P0.05)。治疗后,两组患者营养状况指标白蛋白(ALB)、血红蛋白(Hb)和三头肌肌围(MAMC)水平,肠道有益菌(双歧杆菌、乳杆菌和拟杆菌)数量均有所上升,肠黏膜屏障功能指标二胺氧化酶(DAO)、D-乳酸水平及肠道有害菌数量(小梭菌和肠球菌)均降低。与对照组相比,治疗组患者ALB、Hb和MAMC水平,肠道双歧杆菌、乳杆菌和拟杆菌数量均显著升高,DAO、D-乳酸水平和小梭菌、肠球菌数量均显著降低,差异有统计学意义(P0.05)。治疗组患者消化道并发症发生率均低于对照组(P0.05)。结论双歧杆菌四联活菌片能够显著改善脑卒中患者的营养状况,有效调节菌群失衡,改善肠黏膜屏障功能,降低并发症发生。  相似文献   

3.
目的探讨双歧三联活菌胶囊对胆囊切除术后腹泻(PCD)患者血清D-乳酸及肠道菌群的影响。方法选取80例PCD患者,随机分为观察组(n=40)和对照组(n=40)。两组均予以低脂饮食和止泻药等常规治疗。观察组加用双歧三联活菌胶囊420mg/次,3次/d,连用6周,温开水或温牛奶送服。检测两组治疗前后血清D-乳酸水平及肠道菌群数量变化,并比较其临床疗效及不良反应。结果观察组与对照组分别失访2例(5.0%)和4例(10.0%),两组失访率比较差异无统计学意义(P0.05)。治疗6周后,两组血清D-乳酸指标较治疗前均明显下降(对照组治疗前后比较,P0.05;观察组治疗前后比较,P0.01),观察组下降幅度较对照组更明显(P0.05);同时观察组双歧杆菌和乳酸杆菌数量增加,肠杆菌和肠球菌数量下降(P0.05),而对照组肠道菌群数量变化差异无统计学意义(P0.05);同时观察组其总有效率(92.11%)较对照组(72.22%)高(χ2=5.05,P0.05)。结论双歧三联活菌胶囊治疗PCD具有确切疗效,能降低血清D-乳酸指标,纠正并调节患者肠道微生态紊乱,重建肠道微生态平衡,改善其肠道功能。  相似文献   

4.
目的 探讨非酒精性脂肪性肝炎患者肠道菌群失调与肠道通透性及血清内毒素的相关性.方法 选择肠道菌群中具有代表性的细菌共8种进行培养.研究对象为健康成人(A组)和非酒精性脂肪性肝炎(B组)各30例,计数两组肠道菌群中8种细菌的数量,检测所有被研究者的血清内毒素、二胺氧化酶(DAO)、D-乳酸及TNF-α的浓度,比较两组细菌数量和血清指标的变化,并进行相关分析.结果 与A组比较,B组双歧杆菌、乳杆菌和拟杆菌的菌落数显著减少(P<0.01或P<0.05),而肠球菌、肠杆菌的菌落数则有显著增加(P<0.01或P<0.05);酵母真菌、葡萄球菌、梭菌菌落数没有发生显著改变(P>0.05);血清内毒素、DAO、D-乳酸、TNF-α水平显著增高(P<0.01);相关分析显示肠杆菌与内毒素、DAO、D-乳酸相关(r=0.644,P<0.001;r=0.415,P=0.023;r =0.383,P=0.037);血清内毒素和DAO、D-乳酸、TNF-α显著相关(r=0.485,P=0.007;r=0.477,P=0.008;r=0.490,P=0.006);TNF-α则与DAO、D-乳酸相关(r=0.426,P =0.019;r =0.440,P=0.015).结论 非酒精性脂肪性肝炎患者存在肠道菌群失调、肠道通透性增高及肠源性内毒素血症,肠杆菌的过度生长与肠源性内毒素血症及肠道通透性密切相关.  相似文献   

5.
目的探讨双歧杆菌、嗜热链球菌、保加利亚乳杆菌和嗜酸乳杆菌四联活菌制剂对危重症患者肠道屏障功能的影响及疗效观察。方法选择新疆维吾尔自治区人民医院重症监护室2014年5月至2015年2月收治的危重症患者中64例肠道屏障功能障碍的患者,按照随机数字表法随机分为观察组和对照组。两组患者均给予基础治疗加营养治疗。在营养治疗方面,对照组给予常规营养治疗,观察组在常规营养治疗的基础上加用四联活菌制剂,800mL/d。观察两组患者在治疗前及治疗后7、14d外周血二胺氧化酶(DAO),血浆D-乳酸,血清内毒素的变化;观察两组患者腹泻治疗情况。结果两组患者治疗后7、14d肠黏膜屏障功能3项指标有明显降低,观察组治疗14d后肠黏膜屏障功能3项指标较对照组降低幅度更大,差异有统计学意义(P0.01)。患者治疗腹泻总有效率观察组为96.7%,对照组为70.0%,两组间比较差异有统计学意义(P0.05)。结论四联活菌制剂可以明显改善危重症患者肠道通透性,同时改善肠道微生态平衡,修复肠黏膜屏障功能,对危重症患者腹泻有显著的治疗作用,进而改善患者的预后,提高临床疗效,应在临床上推广应用。  相似文献   

6.
目的探讨双歧杆菌三联活菌肠溶胶囊对重症肺炎患者肠黏膜屏障功能的保护作用。方法选取重症肺炎患者66例,随机分为观察组(n=33例)和对照组(n=33例)。两组患者均予以吸氧、抗感染、抗休克和营养支持等常规治疗,必要时行机械通气或血管活性药物。观察组患者加用双歧杆菌三联活菌肠溶胶囊420 mg,3次/d,温水服用或水化后自鼻饲注入。观察两组患者治疗前和治疗14 d后内毒素、二胺氧化酶(DAO)和D-乳酸水平的变化,并比较其临床疗效。结果治疗14 d后,两组患者血清内毒素、DAO和D-乳酸水平均较前明显下降(P〈0.01或P〈0.05),且观察组下降值明显大于对照组(P〈0.05);同时观察组患者的临床总有效率明显高于对照组(χ2=3.88,P〈0.05)。结论双歧杆菌三联活菌肠溶胶囊辅助治疗重症肺炎患者具有较好的疗效,能明显降低血清内毒素、DAO和D-乳酸水平,减轻患者内毒素血症和肠黏膜通透性,保护患者肠黏膜屏障功能。  相似文献   

7.
目的:观察腹腔感染大鼠肠屏障损伤后肠道通透性的改变与I-FABP表达的关系.方法:清洁级健康的成年雄性Wistar大鼠40只,随机分为空白对照组(仅行简单的剖腹手术)和腹腔感染(采用CLP盲肠结扎穿孔法制作腹腔感染模型)术后12h、24 h、36h、48 h组,每组8只,相应时间点处死大鼠后,测定血浆D-乳酸和I-FABP含量.结果:腹腔感染后12h,大鼠血浆D-乳酸含量开始增加(P<0.05),血浆I-FABP含量也开始增加(P<0.01);血浆D-乳酸含量在24 h达到最高值(P<0.01),血浆I-FABP含量在36h达到最高值(P<0.01).大鼠血浆D-乳酸水平与I-FABP具有显著相关性(r=0.626,P<0.01).结论:腹腔感染状态下,肠屏障严重受损,肠粘膜通透性的改变与血浆I-FABP水平具有显著的相关性.  相似文献   

8.
目的探讨双歧三联活菌胶囊联合早期肠内营养保护呼吸科危重病患者肠黏膜屏障功能作用。方法选取68例呼吸科危重病患者,随机分为联合组和对照组各34例。两组患者均予以留置胃管鼻饲行早期肠内营养。联合组患者在此基础上加用双歧三联活菌肠溶胶囊630mg研磨水化后自留置鼻饲管内注入,3次/d,连用14d。判断并比较两组患者治疗前和治疗14d后营养指标及肠黏膜屏障指标的变化。结果治疗14d后,两组患者白蛋白(ALB)、淋巴细胞总数(LYM)和三头肌皮褶厚度(TSF)指标均较前明显下降(t=2.17、2.24、2.39、2.91、3.03、3.42,P0.05或P0.01),且联合组的下降幅度明显低于对照组(t=2.15、2.24、2.22,P0.05);同时两组患者血清二胺氧化酶(DAO)和D-乳酸指标较前均明显下降(t=2.97、3.43、2.26、2.38,P0.05或P0.01),且联合组的下降值较对照组更明显(t=2.19、2.31,P0.05)。结论双歧三联活菌胶囊联合早期肠内营养可减轻或纠正呼吸科危重病患者的负氮平衡,减缓其营养状况恶化;并可下调血清DAO和D-乳酸指标,保护与改善其肠黏膜屏障功能,加快患者康复。  相似文献   

9.
目的探讨强化胰岛素治疗对脓毒症患者血清D-乳酸及前降钙素水平的影响及疗效观察。方法选取脓毒症患者72例,随机分为强化组和对照组,每组36例。两组患者均予以抗生素抗感染、能量支持及治疗基础疾病等常规治疗,必要时行机械通气或血管活性药物。强化组患者将50 U胰岛素加入50 mL生理盐水中微量泵控制血糖5.0~7.0 mmol/L;对照组患者血糖控制在10.0~11.9 mmol/L,当血糖超过时才加用胰岛素治疗。观察两组患者治疗前和治疗7 d后血清D-乳酸及前降钙素水平的变化,并比较其临床疗效。结果治疗7 d后,两组患者血清D-乳酸及前降钙素水平均较前明显下降(P〈0.01或P〈0.05),且强化组下降值明显大于对照组(P〈0.05);强化组患者的临床总有效率明显高于对照组(94.44%vs.77.78%)(χ2=4.18,P〈0.05)。结论强化胰岛素治疗脓毒症患者具有较好的临床疗效,能明显降低血清D-乳酸及前降钙素水平的影响,改善肠黏膜屏障功能。  相似文献   

10.
目的探讨双歧三联活菌胶囊对结直肠癌术后肠道菌群及肠黏膜通透性的影响。方法选取拟行手术治疗的结直肠癌患者78例,随机分为观察组和对照组。两组患者术前常规禁食、肠道准备,采用开放根治性结/直肠癌切除手术治疗,术后予以围手术期常规治疗,并予以等氮量、等热量的营养支持。观察组术后第3天加用双歧三联活菌胶囊630mg/次,2次/d,连用7d。观察两组患者术前及治疗7d后肠道菌群(双歧杆菌、乳酸杆菌、大肠埃希菌和粪肠球菌)及肠黏膜通透性指标[血清二胺氧化酶(DAO)]的变化,并比较感染并发症的发生率。结果治疗7d后,两组患者双歧杆菌、乳酸杆菌和粪肠球菌数量较前明显下降,大肠埃希菌数量较前明显上升(t=2.17、2.25、2.21、2.32、2.89、3.08、2.97、3.12,P0.05或P0.01),且观察组下降或上升的幅度明显小于对照组(t=2.14、2.25、2.18、2.23,P0.05);两组血清DAO水平均较前明显上升(t=2.27、3.21,P0.05或P0.01),且观察组上升幅度明显小于对照组(t=2.23,P0.05);同时观察组患者感染并发症的总发生率明显低于对照组(χ2=5.03,P0.05)。结论结直肠癌术后存在一定程度的肠道菌群的紊乱,肠黏膜通透性上升和肠道屏障功能受损。双歧三联活菌胶囊用于结直肠癌术后可纠正与调节肠道菌群的紊乱,降低肠黏膜通透性,保护与修复肠黏膜屏障功能,从而减少或避免肠道细菌和内毒素的移位,降低感染并发症的发生。  相似文献   

11.
目的:探讨胰十二指肠切除手术后肠道细菌移位(BT)与术后全身炎症反应综合征(SIRS)关系。方法:40例择期行胰十二指肠切除手术患者,于术前和术后1、3、5天采集外周血,进行血浆D-乳酸,全血细菌DNA检测.全血DNA提取后进行PCR扩增,采用靶基因为大肠杆菌特异性β半乳糖苷酶基因和16SrRNA基因。观察患者术后10天以监测SIRS情况。结果:术前PCR检测全血细菌DNA均为阴性,术后共有13例阳性。术后出现全身炎症反应综合征(SIRS)的患者PCR阳性率为85.7%(12/14),无SIRS组为3.8%(1/26()P〈0.01)。PCR阳性组SIRS发生率为93.2%(12/13),阴性组为7.4%(2/27)(P〈0.01).PCR阳性的患者外周血血浆D-乳酸浓度较PCR阴性者明显升高(P〈0.01),有SIRS的患者外周血血浆D-乳酸浓度较无SIRS患者明显升高(P〈0.01)。结论:胰十二指肠切除术后肠黏膜屏障损伤与BT关系密切,术后SIRS和与BT密切相关。PCR技术对术后SIRS有较好的早期预警价值。  相似文献   

12.
The aim of this study was to evaluate two in vitro models, Caco-2 monolayer and rat intestinal mucosa, regarding their linear correlation with in vivo bioavailability data of therapeutic peptide drugs after oral administration in rat and human. Furthermore the impact of molecular mass (Mm) of the according peptides on their permeability was evaluated. Transport experiments with commercially available water soluble peptide drugs were conducted using Caco-2 cell monolayer grown on transwell filter membranes and with freshly excised rat intestinal mucosa mounted in Using type chambers. Apparent permeability coefficients (P (app)) were calculated and compared with in vivo data derived from the literature. It was shown that, besides a few exceptions, the Mm of peptides linearly correlates with permeability across rat intestinal mucosa (R (2) = 0.86; y = -196.22x + 1354.24), with rat oral bioavailability (R (2) = 0.64; y = -401.90x + 1268.86) as well as with human oral bioavailability (R (2) = 0.91; y = -359.43x + 1103.83). Furthermore it was shown that P (app) values of investigated hydrophilic peptides across Caco-2 monolayer displayed lower permeability than across rat intestinal mucosa. A correlation between P (app) values across rat intestinal mucosa and in vivo oral bioavailability in human (R (2) = 0.98; y = 2.11x + 0.34) attests the rat in vitro model to be a very useful prediction model for human oral bioavailability of hydrophilic peptide drugs. Presented correlations encourage the use of the rat in vitro model for the prediction of human oral bioavailabilities of hydrophilic peptide drugs.  相似文献   

13.
目的:探讨胰十二指肠切除手术后肠道细菌移位(BT)与术后全身炎症反应综合征(SIRS)关系。方法:40例择期行胰十二指肠切除手术患者,于术前和术后1、3、5天采集外周血,进行血浆D-乳酸,全血细菌DNA检测.全血DNA提取后进行PCR扩增,采用靶基因为大肠杆菌特异性β半乳糖苷酶基因和16SrRNA基因。观察患者术后10天以监测SIRS情况。结果:术前PCR检测全血细菌DNA均为阴性,术后共有13例阳性。术后出现全身炎症反应综合征(SIRS)的患者PCR阳性率为85.7%(12/14),无SIRS组为3.8%(1/26()P<0.01)。PCR阳性组SIRS发生率为93.2%(12/13),阴性组为7.4%(2/27)(P<0.01).PCR阳性的患者外周血血浆D-乳酸浓度较PCR阴性者明显升高(P<0.01),有SIRS的患者外周血血浆D-乳酸浓度较无SIRS患者明显升高(P<0.01)。结论:胰十二指肠切除术后肠黏膜屏障损伤与BT关系密切,术后SIRS和与BT密切相关。PCR技术对术后SIRS有较好的早期预警价值。  相似文献   

14.
The permeability of the gut mucosa to macromolecules has been examined in 4 different strains of rats infected with Nippostrongylus brasiliensis (N. brasiliensis). There is a marked increase in mucosal permeability during the infection. In addition, a considerable strain difference is observed in both worm burden kinetics and the kinetics of intestinal permeability. The dose-response and drug treatment experiments in outbred Wistar rats suggest that increased mueosal permeability is a function of the worm burden. However, the increased permeability is related neither to the rapid phase of worm expulsion nor to the rise in intestinal mast cell numbers.  相似文献   

15.
目的:探讨梗阻性黄疸大鼠行胆汁内、外引流术后血浆二胺氧化酶的活性变化与肠粘膜屏障的关系。方法:取健康成年雄性SD大鼠60只,随机分为四组:梗阻性黄疸组(OJ)、胆汁外引流组(ED)、胆汁内引流组(ID)及假手术对照组(SH),各组均15只;SH组、OJ组在术后第7天处死大鼠并采集标本,ID组、ED组于引流术后7天处死大鼠并采集标本,检测各组大鼠血浆DAO的活性,光镜下观察末端回肠组织粘膜形态学变化。结果:OJ组大鼠肠粘膜损伤明显,粘膜变薄、绒毛稀疏、上皮完整性受到破坏并伴有炎性细胞浸润,ID、ED组大鼠肠粘膜有不同程度的恢复,ID组更接近SH组;OJ组血浆DAO水平显著升高,明显高于SH、ID、ED组(8.183±0.211 vs 3.570±0.280、3.978±0.269、5.051±0.328 U/L,P0.01),ID组较ED组下降更明显,二者差异有统计学意义(P0.01),ID组血浆DAO水平略高于SH组,二者差异无统计学意义(P0.05);各组血浆DAO变化与肠粘膜组织病理学变化一致。结论:胆汁内、外引流术可降低梗阻性黄疸大鼠血浆DAO水平,内引流术效果优于外引流术;血浆DAO的变化可反映梗黄大鼠肠粘膜屏障损伤及修复情况。  相似文献   

16.
目的:探讨口服肠内营养制剂对老年吻合器痔上黏膜环切钉合术(PPH)术后患者营养状况及排便的影响。方法:选择2013年1月-2015年1月在我院行PPH治疗的老年患者120例,依据随机数字表法将患者分为对照组(n=60)和观察组(n=60),术后对照组通过静脉补液的方式给予常规肠外营养,观察组口服肠内营养剂安素,两组营养支持均维持3-5天。比较两组患者术前和术后3d血白蛋白(ALB)、前白蛋白(PA)、淋巴细胞计数(LYC)、血红蛋白(Hb)的差异,记录两组患者术后首次排便时间和3d内的排便次数。结果:术后第3d,观察组PA和LYC显著高于对照组,差异有统计学意义(P0.05);两组术后排便次数和首次排便时间差异均无统计学意义(P0.05)。结论:口服肠内营养制剂作为老年PPH术后患者的营养支持方式,能满足老年患者的营养需求,改善免疫功能,并且不刺激排便,值得临床推广使用。  相似文献   

17.
Numb is highly expressed throughout the crypt-villus axis of intestinal mucosa and functions as cell fate determinant and integrator of cell-to-cell adhesion. Increased paracellular permeability of intestinal epithelial cells is associated with the epithelial barrier dysfunction of inflammatory bowel diseases (IBDs). The apical junctional complex (AJC) assembly and myosin light chain (MLC) phosphorylation regulate adherens junctions (AJ) and tight junctions (TJ). We determined whether and how Numb modulate the paracellular permeability of intestinal epithelial cells. Caco-2 intestinal epithelial cells and their Numb-interfered counterparts were used in the study for physiological, morphological and biological analyses. Numb, expressed in intestinal epithelial cells and located at the plasma membrane of Caco-2 cells in a basolateral to apical distribution, increased in the intestinal epithelial cells with the formation of the intestinal epithelial barrier. Numb expression decreased and accumulated in the cytoplasm of intestinal epithelial cells in a DSS-induced colitis mouse model. Numb co-localized with E-cadherin, ZO-1 and Par3 at the plasma membrane and interacted with E-cadherin and Par3. Knockdown of Numb in Caco-2 cells altered the F-actin structure during the Ca2+ switch assay, enhanced TNFα-/INF-γ-induced intestinal epithelial barrier dysfunction and TJ destruction, and increased the Claudin-2 protein level. Immunofluorescence experiments revealed that NMIIA and F-actin co-localized at the cell surface of Caco-2 cells. Numb knockdown in Caco-2 cells increased F-actin contraction and the abundance of phosphorylated MLC. Numb modulated the intestinal epithelial barrier in a Notch signaling-independent manner. These findings suggest that Numb modulates the paracellular permeability by affecting AJC assembly and MLC phosphorylation.  相似文献   

18.
Intestinal barrier dysfunction often occurs in various acute or chronic pathological conditions and has been identified as an important clinical problem. Herein, we explored the biological role and molecular mechanism of Polo-like kinase 1 (PLK1) and differentiation antagonizing non-protein coding RNA (DANCR) in intestinal barrier dysfunction caused by sepsis. RT-qPCR analysis was used to examine PLK1, miR-1306-5p, and DANCR expression in NCM460 cells after LPS treatment. TUNEL assay and Western blot analysis were performed to explore PLK1 function in cell apoptosis and intestinal barrier in vitro. Hematoxylin and eosin staining, Western blot analysis, and TUNEL assay were used to investigate DANCR function in the intestinal barrier and cell apoptosis in vivo. The interaction between miR-1306-5p and PLK1 (or DANCR) was validated by luciferase reporter assay. As a result, PLK1 overexpression decreased cell apoptosis and promoted intestinal barrier function. Moreover, DANCR was validated as a sponge of miR-1306-5p to target PLK1. In addition, we found that DANCR overexpression decreased intestinal mucosal permeability and colon mucosa epithelial cell apoptosis in vivo. Conclusively, DANCR improved intestinal barrier dysfunction and alleviated epithelial injury by targeting the miR-1306-5p/PLK1 axis in sepsis.  相似文献   

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