实用医学杂志 ›› 2021, Vol. 37 ›› Issue (3): 343-347.doi: 10.3969/j.issn.1006⁃5725.2021.03.013

• 临床研究 • 上一篇    下一篇

调节肠道菌群微生态对老年肝硬化患者腹膜炎治疗效果和预后的影响

买热木古·阿布都热依木,方法,穆清爽,孙军   

  1. 1 新疆医科大学第二附属医院老年病科(干部病房)(乌鲁木齐830000);2 南方医科大学深圳医院普通外科(广东深圳518100);
    3 新疆医科大学公共卫生学院(乌鲁木齐 830011)
  • 出版日期:2021-02-10 发布日期:2021-02-10
  • 通讯作者: 穆清爽 E⁃mail:yuxinsunjuan@163.com
  • 基金资助:
    新疆维吾尔自治区自然科学基金项目(编号:2018D01C112);吴阶平医学基金会临床科研专项资助基金(编号:320.6750.19073⁃29)

The effect of regulation of intestinal microflora on the peritonitis therapeutic effect nd prognosis of elderly patients with liver cirrhosis

BUY REMUGU· Abu Dureyimu,FANG Fa ,MU Qingshuang ,SUN Jun.#br#   

  1. The Second Affiliated Hospital of Xinjiang Medical University,Geriatric Diseases(cadre ward),Urumqi 830000,China
  • Online:2021-02-10 Published:2021-02-10
  • Contact: MU Qingshuang E⁃mail:yuxinsunjuan@163.com

摘要:

目的 探讨调节肠道菌群微生态对老年肝硬化患者腹膜炎治疗效果和预后的影响。 方法 将所有纳入患者分为观察组和对照组,使用倾向性评分匹配法对两组患者治疗前各临床因素进 匹配,得到治疗前组间临床因素均衡的样本,两独立样本 t 检验比较匹配后两组患者腹膜炎治疗效果,采 Cox 回归模型评价观察组对腹膜炎治疗时间和肝硬化无进展生存情况的影响,Kaplan⁃Meier 生存分析比 较两组患者腹胀、腹水持续时间累计率以及肝硬化无进展生存率差异有统计学意义(P<0.05)。研究共纳入 240 例老年肝硬化腹膜炎患者,根据治疗不同分为观察组和对照组。使用倾向性评分匹配法, 两组共 61 对匹配成功 ,匹配后,观察组腹膜炎治疗 2 周后肝功能和腹膜炎指标改善显著优于对照组,Cox 回归模型显示观察组显著缩短腹膜炎治疗时间(HR = 0.62,95%CI:0.35~0.98,P < 0.05);观察组患者肝硬 化无进展生存时间显著高于对照组(HR = 0.58,95%CI:0.39~0.72,P < 0.05),Kaplan⁃Meier 生存分析显示: 观察组持续 8、10、14 d 腹胀、腹水累计率显著低于对照组(75.3%、48.6%、22.4% vs. 90.2%、83.4%、28.2%, P < 0.05);观察组 6 个月和 1、2 年肝硬化无进展生存率显著高于对照组(90.2%、78.1%、23.8% vs. 75.2%、 54.3%、11.6%,P < 0.05)。结论 微生态制剂对老年肝硬化合 并自发性腹膜炎有明显的治疗作用,同时预 防肝病重型化,延长肝硬化无进展生存时间,使患者获得临床获益。

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Abstract:

Objective To investigate the effects of intestinal microflora on the peritonitis therapeutic effect and prognosis of elderly patients with liver cirrhosis. Methods All patients were divided into the study group and the control group. To begin with,propensity score matching method was used to match the clinical factors between the two groups before treatment,and the samples with balanced clinical factors before treatment were obtained,then,two independent samples t⁃test was used to compare the peritonitis treatment effect between the two matched groups,furthermore,Cox regression model was used to evaluate the effect of the study group on peritonitis treatment time and liver cirrhosis progression free survival. Finally,Kaplan⁃Meier survival analysis was used to compare abdominal distension,ascites duration cumulative rate and liver cirrhosis free progression survival rate between the two matched groups,P < 0.05,the difference was statistically significant. Results A total of 240 elderly cirrhotic peritonitis patients were enrolled and divided into study⁃ and control group according to differ⁃ ent treatment. Using propensity score matching method,a total of 61 pairs of the two groups were successfully matched. After matching,the liver function and peritonitis indexes of the study group were significantly better than those of the control group after 2 weeks of peritonitis treatment,Cox regression model showed the peritonitis treat⁃ ment time of the study group was significantly shortened(HR:0.62;95% CI:0.35 ~ 0.98;P < 0.05),and the liver cirrhosis free progression survival time of the study group was significantly higher than that of the control group(HR:0.58;95% CI:0.35 ~ 0.98;P < 0.05);95% CI:0.39 ~ 0.72;P < 0.05). Kaplan⁃Meier survival analysis showed the lasted for 8 days,10 days and 14 days abdominal distension and ascites accumulation rate in the study group were significantly lower than those in the control group(75.3% ,48.6% ,22.4% vs. 90.2% 83.4%,28.2%,P < 0.05);the 6⁃month,1⁃year,2⁃year liver cirrhosis free progression survival rate in the study group was significantly higher than that in the control group(90.2%,78.1%,23.8% vs 75.2%,54.3%,11.6% P < 0.05). Conclusion Probiotics has obvious therapeutic effect on elderly patients with liver cirrhosis complicated with spontaneous peritonitis,at the same time it can prevent liver disease from becoming severe,prolong the liver cirrhosis free progression survival time ,and make patients obtain clinical benefits.

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