益生菌对克罗恩病患者肠道屏障功能和免疫调节的影响

研究益生菌对克罗恩病患者肠道屏障功能和免疫调节的影响，为该类患者的治疗提供参考。

选择2018年1月至2020年6月我院收治的94例克罗恩病患者进行前瞻性随机对照研究，根据住院尾号单双数随机分为单号的对照组（n = 45）和双号的益生菌组（n = 49）。对照组患者给予柳氮磺胺吡啶联合安慰剂治疗，益生菌组患者给予柳氮磺胺吡啶联合双歧杆菌三联活菌片治疗。治疗前及治疗后2个月时，分别检测患者粪便中肠道菌群数量，简化克罗恩病活动指数（CDAI），血沉（ERS），血清中超敏C反应蛋白（hs-CRP）、二胺氧化酶、D-乳酸、干扰素-γ（IFN-γ）、白介素（IL）-4、IL-10、IL-17的水平以及外周血中Th1、Th2、Th17、Treg细胞的数目。随访2组患者预后不良终点事件的累积发生率。

治疗后2个月，益生菌组患者粪便中拟杆菌、肠杆菌、肠球菌的数量，简化CDAI、ERS水平，血清中hs-CRP、二胺氧化酶、D-乳酸、IFN-γ、IL-17水平，外周血中Th1、Th17的数量均低于对照组；而粪便中双歧杆菌、乳杆菌数量，血清中IL-4、IL-10水平，外周血中Th2、Treg的数量均高于对照组（均P＜0.05）。随访过程中，益生菌组患者预后不良终点事件的累积发生率低于对照组（P＜0.05）。

益生菌能够改善克罗恩病患者病情及肠道屏障功能，调节免疫应答，同时也对预后具有改善作用。

Effects of probiotics on intestinal barrier function and immune regulation in patients with Crohn's disease

Objective To observe the effects of probiotics on intestinal barrier function and immune regulation in patients with Crohn's disease (CD), and provide a reference for the treatment. Methods A total of 94 patients with CD treated in our hospital from January 2018 to June 2020 were enrolled for prospective randomized controlled study, and randomly divided into control group (n = 45) with singular number and probiotic group (n = 49) with even number according to the inpatient tail number. The control group was treated with Sulfasalazine combined with placebo, while the probiotic group was treated with Sulfasalazine combined with triple viable Bifidobacterium tablets. Before and 2 months after treatment, the counts of intestinal flora, simplified Crohn's disease activity index (CDAI), erythrocyte sedimentation rate (ERR), the contents of serum high-sensitivity C-reactive protein (hs-CRP), diamine oxidase, D-lactic acid and interferon-γ (IFN-γ), interleukin (IL)-4, IL-10 and IL-17, and numbers of immune cells Th1, Th2, Th17 and Treg in peripheral blood were measured, and the cumulative incidence of adverse prognostic end points in the two groups were followed up. Results Two months after treatment, the counts of Bacteroides, Enterobacter and Enterococcus in feces, simplified CDAI, ERS level, contents of hs-CRP, diamine oxidase, D-lactic acid and IFN-γ, IL-17 in serum, and numbers of Th1 and Th17 in peripheral blood in probiotic group were lower than those in the control group respectively; the counts of Bifidobacteria and Lactobacillus in feces, contents of IL-4 and IL-10 in serum, and numbers of Th2 and Treg in peripheral blood were higher than those in the control group respectively (all P＜0.05). During the follow-up, the cumulative incidence of adverse end points in the probiotic group was lower than that in the control group (all P＜0.05). Conclusion Probiotics in the treatment of Crohn's disease can not only improve the condition and intestinal barrier function, regulate immune response, but also optimize the prognosis.