Ann Palliat Med:外源性益生菌对危重病人肠道微生物群和临床结果的影响

2021-07-31 MedSci原创 MedSci原创

肠道微生物群在炎症中起着重要作用。近日,一项单盲、随机对照试验探究了外源性益生菌是否可以通过减弱炎症和免疫调节来改善肠道屏障功能的效果,从而改善重症患者的临床结果,研究结果已发表于Ann Pallia

肠道微生物群在炎症中起着重要作用。近日,一项单盲、随机对照试验探究了外源性益生菌是否可以通过减弱炎症和免疫调节来改善肠道屏障功能的效果,从而改善重症患者的临床结果,研究结果已发表于Ann Palliat Med。

研究在呼吸科重症监护室(RICUs)进行,干预组患者接受益生菌丁酸梭菌的治疗直到死亡或出院。在用药的第1天和第15天收集粪便和血液样本。在随访期间记录主要的临床结果和临床表现。

 

结果,共纳入了61名患者,其中28名患者接受了益生菌。干预组和对照组在死亡率和住院时间方面没有差异。此外,与对照组相比,干预组的发热时间(住院时间的百分比)明显缩短(4.85% vs. 12.94%,P=0.00)。干预组的便秘发生率明显减少(17.86% vs. 42.42%,P=0.04)。他们之间的胃肠道不良反应的总比率相当。益生菌干预后,杀菌剂明显减少(Δm=-0.69,P=0.048),而干预组大肠杆菌和肠球菌在第15天趋于减少(Δm=-0.65,P=0.08;Δm=-0.52,P=0.22)。在益生菌干预后,没有观察到双歧杆菌和乳酸杆菌的波动。

综上,该研究未能显示益生菌对危重病人的主要临床结果的有益影响。肠道屏障受损,益生菌可能会减少肠道的Gm-细菌的负担。

 

原始出处:

 

Jie Wang, et al., Effects of exogenous probiotics on the gut microbiota and clinical outcomes in critically ill patients: a randomized controlled trial. Ann Palliat Med. 2021 Feb;10(2):1180-1190. doi: 10.21037/apm-20-202.  

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    2021-08-18 zhangph
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    2022-04-24 wjcjjian
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createdName=wjcjjian, createdTime=Sun Apr 24 13:04:34 CST 2022, time=2022-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1898875, encodeId=a7a218988e583, content=<a href='/topic/show?id=729322969b9' target=_blank style='color:#2F92EE;'>#临床结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22969, encryptionId=729322969b9, topicName=临床结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4fd6156, createdName=oliver169, createdTime=Mon Apr 04 04:04:34 CST 2022, time=2022-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1690485, encodeId=94f316904855e, content=<a href='/topic/show?id=fdb336e49bb' target=_blank style='color:#2F92EE;'>#危重病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36749, 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channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2328, encryptionId=bb96232801, topicName=ALL)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/C2EFD5CFB07FE291138AD4FD0C98E3DE/100, createdBy=e3d52500031, createdName=膀胱癌, createdTime=Mon Aug 02 08:04:34 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367858, encodeId=fcce136e858c7, content=<a href='/topic/show?id=2cee50e22c6' target=_blank style='color:#2F92EE;'>#微生物群#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50722, encryptionId=2cee50e22c6, topicName=微生物群)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3609256, createdName=zhu_jun9837, createdTime=Mon Aug 02 08:04:34 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1533259, encodeId=073f15332593b, content=<a href='/topic/show?id=c3c236e5229' target=_blank style='color:#2F92EE;'>#危重病人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36752, encryptionId=c3c236e5229, topicName=危重病人)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=53bc12401014, createdName=listen322, createdTime=Mon Aug 02 08:04:34 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1611188, encodeId=2a8b161118834, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Mon Aug 02 08:04:34 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1004242, encodeId=8db21004242cb, content=的呼吸嘻嘻嘻嘻, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210616/0f0e195fe7b24d569a1f39751df92fe2/ae01b1208252480f9e001617ce565271.jpg, createdBy=91e25526337, createdName=土豆你个马铃薯, createdTime=Sat Jul 31 17:26:16 CST 2021, time=2021-07-31, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1989787, encodeId=3cee1989e8781, content=<a href='/topic/show?id=5c3c428850d' target=_blank style='color:#2F92EE;'>#外源性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42885, encryptionId=5c3c428850d, topicName=外源性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6976269, createdName=zhangph, createdTime=Wed Aug 18 05:04:34 CST 2021, time=2021-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1825313, encodeId=5244182531376, content=<a href='/topic/show?id=702a5065860' target=_blank style='color:#2F92EE;'>#微生物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50658, encryptionId=702a5065860, topicName=微生物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Sun Apr 24 13:04:34 CST 2022, time=2022-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1898875, encodeId=a7a218988e583, content=<a href='/topic/show?id=729322969b9' target=_blank style='color:#2F92EE;'>#临床结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22969, encryptionId=729322969b9, topicName=临床结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4fd6156, createdName=oliver169, createdTime=Mon Apr 04 04:04:34 CST 2022, time=2022-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1690485, encodeId=94f316904855e, content=<a href='/topic/show?id=fdb336e49bb' target=_blank style='color:#2F92EE;'>#危重病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36749, encryptionId=fdb336e49bb, topicName=危重病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=27f729051889, createdName=xinmeili, createdTime=Fri Jul 01 22:04:34 CST 2022, time=2022-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1298886, encodeId=46261298886ad, content=<a href='/topic/show?id=2088816e487' target=_blank style='color:#2F92EE;'>#肠道微生物群#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81674, encryptionId=2088816e487, topicName=肠道微生物群)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e43278, createdName=yangjxjc, createdTime=Mon Aug 02 08:04:34 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1329538, encodeId=c19e13295381a, content=<a href='/topic/show?id=bb96232801' target=_blank style='color:#2F92EE;'>#ALL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2328, encryptionId=bb96232801, topicName=ALL)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/C2EFD5CFB07FE291138AD4FD0C98E3DE/100, createdBy=e3d52500031, createdName=膀胱癌, createdTime=Mon Aug 02 08:04:34 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367858, encodeId=fcce136e858c7, content=<a href='/topic/show?id=2cee50e22c6' target=_blank style='color:#2F92EE;'>#微生物群#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50722, encryptionId=2cee50e22c6, topicName=微生物群)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3609256, createdName=zhu_jun9837, createdTime=Mon Aug 02 08:04:34 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1533259, encodeId=073f15332593b, content=<a href='/topic/show?id=c3c236e5229' target=_blank style='color:#2F92EE;'>#危重病人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36752, encryptionId=c3c236e5229, topicName=危重病人)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=53bc12401014, createdName=listen322, createdTime=Mon Aug 02 08:04:34 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1611188, encodeId=2a8b161118834, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Mon Aug 02 08:04:34 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1004242, encodeId=8db21004242cb, content=的呼吸嘻嘻嘻嘻, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210616/0f0e195fe7b24d569a1f39751df92fe2/ae01b1208252480f9e001617ce565271.jpg, createdBy=91e25526337, createdName=土豆你个马铃薯, createdTime=Sat Jul 31 17:26:16 CST 2021, time=2021-07-31, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1989787, encodeId=3cee1989e8781, content=<a href='/topic/show?id=5c3c428850d' target=_blank style='color:#2F92EE;'>#外源性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42885, encryptionId=5c3c428850d, topicName=外源性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6976269, createdName=zhangph, createdTime=Wed Aug 18 05:04:34 CST 2021, time=2021-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1825313, encodeId=5244182531376, content=<a href='/topic/show?id=702a5065860' target=_blank style='color:#2F92EE;'>#微生物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50658, encryptionId=702a5065860, topicName=微生物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Sun Apr 24 13:04:34 CST 2022, time=2022-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1898875, encodeId=a7a218988e583, content=<a href='/topic/show?id=729322969b9' target=_blank style='color:#2F92EE;'>#临床结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22969, encryptionId=729322969b9, topicName=临床结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4fd6156, createdName=oliver169, createdTime=Mon Apr 04 04:04:34 CST 2022, time=2022-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1690485, encodeId=94f316904855e, content=<a href='/topic/show?id=fdb336e49bb' target=_blank style='color:#2F92EE;'>#危重病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36749, encryptionId=fdb336e49bb, topicName=危重病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=27f729051889, createdName=xinmeili, createdTime=Fri Jul 01 22:04:34 CST 2022, time=2022-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1298886, encodeId=46261298886ad, content=<a href='/topic/show?id=2088816e487' target=_blank style='color:#2F92EE;'>#肠道微生物群#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81674, encryptionId=2088816e487, topicName=肠道微生物群)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e43278, createdName=yangjxjc, createdTime=Mon Aug 02 08:04:34 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1329538, encodeId=c19e13295381a, content=<a href='/topic/show?id=bb96232801' target=_blank style='color:#2F92EE;'>#ALL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2328, encryptionId=bb96232801, topicName=ALL)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/C2EFD5CFB07FE291138AD4FD0C98E3DE/100, createdBy=e3d52500031, createdName=膀胱癌, createdTime=Mon Aug 02 08:04:34 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367858, encodeId=fcce136e858c7, content=<a href='/topic/show?id=2cee50e22c6' target=_blank style='color:#2F92EE;'>#微生物群#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50722, encryptionId=2cee50e22c6, topicName=微生物群)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3609256, createdName=zhu_jun9837, createdTime=Mon Aug 02 08:04:34 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1533259, encodeId=073f15332593b, content=<a href='/topic/show?id=c3c236e5229' target=_blank style='color:#2F92EE;'>#危重病人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36752, encryptionId=c3c236e5229, topicName=危重病人)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=53bc12401014, createdName=listen322, createdTime=Mon Aug 02 08:04:34 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1611188, encodeId=2a8b161118834, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Mon Aug 02 08:04:34 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1004242, encodeId=8db21004242cb, content=的呼吸嘻嘻嘻嘻, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210616/0f0e195fe7b24d569a1f39751df92fe2/ae01b1208252480f9e001617ce565271.jpg, createdBy=91e25526337, createdName=土豆你个马铃薯, createdTime=Sat Jul 31 17:26:16 CST 2021, time=2021-07-31, status=1, ipAttribution=)]
    2021-08-02 膀胱癌
  7. [GetPortalCommentsPageByObjectIdResponse(id=1989787, encodeId=3cee1989e8781, content=<a href='/topic/show?id=5c3c428850d' target=_blank style='color:#2F92EE;'>#外源性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42885, encryptionId=5c3c428850d, topicName=外源性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6976269, createdName=zhangph, createdTime=Wed Aug 18 05:04:34 CST 2021, time=2021-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1825313, encodeId=5244182531376, content=<a href='/topic/show?id=702a5065860' target=_blank style='color:#2F92EE;'>#微生物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50658, encryptionId=702a5065860, topicName=微生物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, 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  8. 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  9. 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    2021-07-31 土豆你个马铃薯

    的呼吸嘻嘻嘻嘻

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Clin Infect Dis: 戒骄戒躁、吸取经验、勇往直前,促进展粪菌移植研究发展

目前在微生物区系组成和宿主-微生物群相互作用方面的知识差距为FMT留下了很大的改进空间。我们必须保持冷静,勇往直前,吸取经验教训,始终超前思考。

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Jennifer H. Hill等在CELL杂志发文描述了身体的主要器官系统,并基于无菌和非生物动物研究总结了导致器官系统疾病的体内平衡缺陷。