Effect of probiotic intervention on intestinal flora and immune status in patients with secondary infections to HBV-related acute-on-chronic liver failure

Renguo YANG; Kaiju XU; Qiaoling ZHOU; Xingxiang YANG

doi:10.16016/j.1000-5404.201811037

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Effect of probiotic intervention on intestinal flora and immune status in patients with secondary infections to HBV-related acute-on-chronic liver failure

更新时间：2026-03-02

- Effect of probiotic intervention on intestinal flora and immune status in patients with secondary infections to HBV-related acute-on-chronic liver failure
- Journal of Third Military Medical University Vol. 41, Issue 8, Pages: 794-798(2019)
- 作者机构：
  
  610072 成都，四川省医学科学院·四川省人民医院感染科Department of Infections, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan Province, 610072, China
- 作者简介：
- 基金信息：
  
  the Project of Health and Family Planning Commission of Sichuan Province(100523)
- DOI：10.16016/j.1000-5404.201811037
  CLC： R378.2;R574;R575.3
- Received：07 November 2018，
  
  Published：30 April 2019
- 稿件说明：
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Renguo YANG, Kaiju XU, Qiaoling ZHOU, et al. Effect of probiotic intervention on intestinal flora and immune status in patients with secondary infections to HBV-related acute-on-chronic liver failure[J]. Journal of Third Military Medical University, 2019, 41(8): 794-798.
DOI：

Renguo YANG, Kaiju XU, Qiaoling ZHOU, et al. Effect of probiotic intervention on intestinal flora and immune status in patients with secondary infections to HBV-related acute-on-chronic liver failure[J]. Journal of Third Military Medical University, 2019, 41(8): 794-798. DOI： 10.16016/j.1000-5404.201811037.

摘要

目的

分析益生菌对乙肝病毒相关慢加急性肝衰竭(HBV-related acute-on-chronic liver failure，HBV-ACLF)继发感染患者肠道菌群及免疫状态的影响。

方法

收集本院2017年1月至2018年6月HBV-ACLF患者101例，分为HBV-ACLF组56例和HBV-ACLF继发感染组45例，另选择健康人67例为对照组。HBV-ACLF组和HBV-ACLF继发感染组均给予1个月的双歧杆菌四联活菌片治疗。记录患者治疗前后及对照组新鲜大便的乳酸杆菌、双歧杆菌、大肠杆菌、肠球菌、酵母菌、葡萄球菌、类杆菌和消化链球菌，收集外周血免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、NK细胞活性、T淋巴细胞亚群(CD3

、CD4

、CD8

和CD4

/CD8

)、C反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)和白细胞介素-8(IL-8)。

结果

治疗前，与对照组比较，HBV-ACLF患者肠道的乳酸杆菌、双歧杆菌、IgA、IgG、IgM、NK、CD4

和CD4

/CD8

显著降低(

0.05)，大肠杆菌、肠球菌、酵母菌、葡萄球菌、类杆菌、消化链球菌、CRP、TNF-α、IL-6和IL-8显著升高(

0.05)。与HBV-ACLF组比较，HBV-ACLF继发感染组患者肠道的乳酸杆菌、双歧杆菌、IgA、IgG、IgM、NK、CD4

和CD4

/CD8

显著降低(

0.05)，大肠杆菌、肠球菌、酵母菌、葡萄球菌、类杆菌、消化链球菌、CRP、TNF-α、IL-6和IL-8显著升高(

0.05)。治疗后HBV-ACLF患者肠道的乳酸杆菌、双歧杆菌、IgA、IgG、IgM、NK、CD4

和CD4

/CD8

均有不同程度升高(

0.05)，大肠杆菌、肠球菌、酵母菌、葡萄球菌、类杆菌、消化链球菌、CRP、TNF-α、IL-6和IL-8均有不同程度降低(

0.05)。3组受试者的CD3

和CD8

差异无统计学意义(

0.05)。

结论

HBV-ACLF继发感染的肠道菌群及免疫状态存在异常，益生菌有助于改善HBV-ACLF继发感染的肠道菌群及免疫状态。

Abstract

Objective

To assess the effect of probiotic intervention on intestinal flora and immune status in patients with secondary infections to HBV-related acute-on-chronic liver failure (HBV-ACLF).

Methods

A total of 101 patients with HBV-ACLF treated in our hospital between January

2017 and June

2018 were enrolled in this study

including 56 without secondary infections (HBV-ACLF group) and 45 with secondary infections to HBV-ACLF (secondary infection group)

with 67 healthy participants as controls. All the patients with HBV-ACLF were treated with bifidobacterium quadruple live bacteria tablets in addition to the routine treatments for 1 month. From all the participants

fecal

specimens were collected before and after the treatment to analyze the changes in

Lactobacillus

Bifidobacterium

Escherichia coli

Enterococcus

yeast

Staphylococcus

Bacteroides

and

Streptococcus mutans

; peripheral blood samples were also obtained for testing the serum levels of immunoglobulin A (IgA)

IgG and IgM using ELISA; the changes in T lymphocyte subsets CD3

CD4

and CD8

were detected using immunofluorescence flow cytometry

and the levels of C-reactive protein (CRP)

tumor necrosis factor-α(TNF-α)

interleukin-6 (IL-6) and interleukin-8(IL-8) were determined using ELISA.

Results

Compared with the control group

the patients with HBV-ACLF in both groups before the treatment showed significantly reduced abundance of intestinal

Lactobacilli

and

Bifidobacteria

and increased abundance of

Escherichia coli

Enterococcus

yeast

Staphylococcus

Bacteroides

and

Streptococcus pneumoniae

(

0.05)

with significantly lowered levels of IgA

IgG

IgM

CD4

and CD4

/CD8

(

0.05) and elevated levels of CRP

TNF-α

IL-6 and IL-8 (

0.05); These changes were even more obvious in patients with secondary infections than in those without infections (

0.05). After the treatment

the intestinal

Lactobacilli

Bifidobacteria

and blood levels of IgA

IgG

IgM

CD4

and CD4

/CD8

increased significantly (

0.05)

and intestinal

Escherichia coli

Enterococcus

yeast

Staphylococcus

Bacteroides

Streptococcus pneumoniae

and the levels of CRP

TNF-α

IL-6 and IL-8 were all decrea

sed in both HBV-ACLF group and the secondary infection group (

0.05). No significant differences in CD3

or CD8

cells were found among the 3 groups either before or after the treatment (

0.05).

Conclusion

The patients with secondary infections to HBV-ACLF have abnormal changes in intestinal flora and immune status

which can be improved by probiotic intervention.

关键词

Keywords

references

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