乳果糖降低非酒精性脂肪性肝炎患者肠道通透性及血清内毒素水平

摘要

Objective To investigate intervention effect of lactulose on intestinal permeability in patients with nonalcoholic steatohepatitis ( NASH ). Methods Thirty healthy adults and sixty patients with NASH were divided into 3 groups; health group (group A) , NASH control group (group B, 30 patients) and lactulose treated group (group C,30 patients). Their serum endotoxin, diamine oxidase, D-Lactate and ALT levels were measured respectively. The group C was treated with lactulose(10 mL/d). After 4 weeks treatment, their serum endotoxin, diamine oxidase, D-Lactate and ALT levels were detected again in group B and C. Results Compared with group A, serum endotoxin, diamine oxidase and D-Lactate levels increased (P <0.01) in group B and C. Four weeks later, serum endotoxin, diamine oxidase, D-Lactate and ALT levels decreased remarkably (P <0. 01 ) in group C, but they did not change obviously in group B (P >0.05). Conclusion Lactulose could effectively decrease intestinal permeability and levels of serum endotoxin in patients with NASH.%目的 探讨乳果糖对非酒精性脂肪性肝炎( non-alcoholic steatohcpatitis,NASH)患者肠道通透性的干预作用.方法 选择健康正常成人30例作为正常对照组(A组),非酒精性脂肪性肝炎共60例,随机分为NASH对照组(B组)和乳果糖干预组(C组)各30例,其中C组给予乳果糖( 10 mL/d)进行干预.检测所有被研究者的血清内毒素、二胺氧化酶(diamine oxidase,DAO)、D-乳酸及ALT的浓度.干预4周后,再次检测B、C两组的血清内毒素、二胺氧化酶(DAO)、D-乳酸及ALT的浓度.结果 与A组比较,治疗前B、C两组内毒素、DAO、D-乳酸水平显著增高(P＜0.01),B组干预前后比较,内毒素、DAO、D-乳酸及ALT水平无显著改变(P＞0.05),而C组干预前后比较,内毒素、DAO、D-乳酸及ALT水平显著降低(P＜0.01).结论 NASH患者血清内毒素水平及肠道通透性增高,乳果糖可降低NASH患者肠道的通透性及血浆内毒素水平.