益生菌干预幽门螺杆菌感染者的观察性研究

An Observational Study on the Intervention of Probiotics in Patients with Helicobacter pylori Infection

摘要: 目的：近年来，幽门螺杆菌(Hp)根治方案不断引起关注。本研究旨在通过对Hp阳性患者进行益生菌(罗伊氏乳杆菌DSM17648)干预，观察干预前后人体成分指标以及生化代谢指标的变化，探索Hp感染与人体代谢的相关性，为Hp感染及其相关疾病患者的诊疗提供新思路。方法：自身对照临床观察性研究，对无症状体检但13C尿素呼气试验阳性者，给予1个月的常规饮食控制、生活方式指导建议、以及益生菌(罗伊氏乳杆菌DSM17648)干预，未给予其他抗Hp治疗，观察受试者干预前后：尿素呼气试验13C的变化，干预前后人体成分指标(体重、脂肪量、骨骼肌量、水分等)、以及生化代谢指标(血糖、甘油三酯、总胆固醇、高密度脂蛋白等)，分析Hp感染与上述指标的相关性。结果：纳入22例体检13C尿素呼气试验阳性者，完成研究资料完整共15人。所有纳入者采用同一个益生菌干预方案。干预28 ± 7天后，干预前后13C呼气试验平均值；36.5 ± 23.5 vs. 33.2 ± 22.2，其中三例复查13C呼气试验阴性，干预期结束一月后随访仍是阴性。干预前后人体指标：体重平均值：60.0 ± 13.1 kg vs. 60.3 ± 12.9 kg；脂肪平均值：15.1 ± 5.9 kg vs. 15.8 ± 6.4 kg；骨骼肌平均值：28.8 ± 6.6 kg vs. 30.1 ± 7.3 kg。生化指标：总胆固醇：5.5 ± 2.4 mmol/l vs. 4.8 ± 0.7 mmol/l；高密度脂蛋白：1.5 ± 0.4 mmol/l vs. 2.3 ± 0.8 mmol/l (p = 0.002 < 0.05)。干预前13C呼气试验数值与血糖值相关性分析p = 0.043 (<0.05)。结论：Hp感染者给予益生菌(罗伊氏乳杆菌DSM17648)干预后，13C呼气试验指标下降，人体指标、生化指标均有变化；患者Hp感染与血糖有一定的相关性，对Hp感染者及其相关疾病均有启发指导意义。

Abstract: Objective: Recently, the radical treatment of Helicobacter pylori (Hp) has attracted more and more attention. The purpose of this study is to observe the changes of human composition indexes and biochemical metabolism indexes after the intervention of probiotics (Lactobacillus reuteri DSM17648) in Hp patients, and explore the correlation between Hp infection and metabolism, and provide new ideas for the diagnosis and treatment of patients with Hp infection and related diseases. Methods: This was a self-controlled clinical observational study. Humans who were physical examination but positive 13C urea breath test were given diet control, lifestyle guidance and probiotic (Lactobacillus reuteri DSM17648). After the intervention of one month, and without other Anti-Hp treatment. The changes of 13C urea breath test index and human composition indexes were observed (Body Weight, Fat, Skeletal Muscle, Water, etc.), and Biochemical Metabolic Indexes (Blood Glucose, Triglyceride, Total Cholesterol, High Density Lipoprotein, etc.), the correlation between Hp infection and the above indexes were also analyzed. Results: 22 subjects with positive 13C urea breath test were included, and the study data were complete with 15 subjects. All the participants used the same probiotic intervention method. After 28 ± 7 days of intervention, the average value of 13C breath test was 36.5 ± 23.5 vs. 33.2 ± 22.2, of which three cases had negative 13C breath test by the end, a month after the intervention, three interveners were still negative. Body indexes: Body Weight: 60.0 ± 13.1 kg vs. 60.3 ± 12.9 kg; Fat: 15.1 ± 5.9 kg vs. 15.8 ± 6.4 kg; Skeletal Muscle: 28.8 ± 6.6 kg vs. 30.1 ± 7.3 kg. Biochemical Indexes: Total Cholesterol: 5.5 ± 2.4 mmol/L vs. 4.8 ± 0.7 mmol/L; High Density Lipoprotein: 1.5 ± 0.4 mmol/L vs. 2.3 ± 0.8 mmol/L (P = 0.002 < 0.05). Correlation analysis between 13C breath test and Blood Glucose, P = 0.043 (<0.05). Conclusion: After the intervention of probiotics (Lactobacillus reuteri DSM17648) in patients with Hp infection, the indexes of 13C breath test decreased, and the human indexes and biochemical indexes changed as well; there was a certain correlation between Hp infection and Blood Glucose, which had enlightening significance for patients with Hp infection and related diseases.