双歧杆菌四联活菌片对肝硬化白发性细菌性腹膜炎患者肠黏膜屏障和炎症因子的影响

目的探讨双歧杆菌四联活菌片对肝硬化自发性细菌性腹膜炎（SBP）患者肠黏膜屏障和炎症因子的影响。方法选择乙肝后肝硬化SBP患者68例，分为治疗组和对照组。两组患者均予以低盐饮食、护肝利尿、补充白蛋白和抗感染等基础治疗。治疗组在此基础上予以双歧杆菌四联活菌片口服，1．5g／次，3次／d，连用6周。结果治疗6周后，两组血浆内毒素、PCT和尿L／M比值比较均有明显下降（对照组比较P〈0．05，或治疗组比较P〈0．01），且治疗组下降幅度明显优于对照组（P〈0．05）；两组血浆TNF-α、IL-6和IL-10水平均有明显下降（对照组比较P〈0．05，或治疗组比较P〈0．01），且治疗组下降幅度明显优于对照组（P〈0．05）。治疗组临床总有效率明显高于对照组（χ2=8．17，P〈0．01），治疗期间未发生严重的药物不良反应。结论双歧杆菌四联活菌片治疗肝硬化SBP患者具有较好的临床疗效及安全性，对患者肠黏膜屏障功能具有良好保护和改善作用，并能下降血浆TNF—α、IL-6和IL-10水平，具有辅助治疗肝硬化作用。

The effect of bifidobacterium quadruple living bacterium on intestinal mucosal barrier and inflammatory factor of cirrhosis patients with spontaneous bacterial peritonitis

Objective To discuss the effect of bifidobacterium quadruple living bacterium on intestinal mucosal barrier and inflammatory factor of cirrhosis patients with spontaneous bacterial peritonitis （SBP）. Methods 68 cirrhosis patients with SBP were divided into treatment group and control group. All the patients got traditional treatment as low-sah diet, Protect liver diuresis, albumin supply and anti-infection. The patients of treatment group got extra treatment as taking bifidobaeterium quadruple living bacterium orally 1.5 g every time, 3 times per day for 6 weeks. Results After 6 weeks＇ treatment, compared with pretherapy, the blood endotoxin, PCT and urinary L/M of both of the two groups descended significantly （ control group comparison P 〈 0. 05 or treatment group comparison P 〈 0. 01 ） , and the reducing is more obvious in treatment group （ P 〈 0. 05 ） than that in control group. And the blood TNF-α, IL-6 and IL-10 levels of both of the two groups descended significantly （control group comparison P 〈 0. 05 or treatment group comparison P 〈 0. 01 ）, and the reducing was more obvious in treatment group （ P 〈 0.05 ） than that in control group. The total effective rate of treatment group was significant higher than that of control group （P 〈 0. 01 ）. There was no obvious side effect observed during the treatment of the two groups. Conclusion Treating cirrhosis patients with SBP by bifidobacterium quadruple living bacterium shows a good curative effect and high safety. Bifidohacterium quadruple living bacterium can protect and improve the intestinal mucosal barrier, reduce the plasma levels of TNF-α, IL-6 and IL-10, relieve the inflammatory reaction, so it can be a adjunctive therapy for cirrhosis treatment.