益生菌、益生元及合生元对血液透析患者尿毒症毒素、炎症和氧化应激的影响：一项随机对照试验的系统评价和荟萃分析

Effects of Probiotics, Prebiotics, and Synbiotics on Uremic Toxins, Inflammation, and Oxidative Stress in Hemodialysis Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

作者信息

Nguyen Thi Thuy Uyen, Kim Hyeong Wan, Kim Won

机构信息

Department of Histology, Embryology, Pathology and Forensic Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue 52000, Vietnam.

Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju 54896, Korea.

出版信息

J Clin Med. 2021 Sep 28;10(19):4456. doi: 10.3390/jcm10194456.

The dysbiosis of gut microbiota may cause many complications in patients with end-stage renal disease, which may be alleviated by probiotic, prebiotic, and synbiotic supplementation. The aim of this systematic review and meta-analysis was to assess the effects of these supplementations on circulatory uremic toxins, biomarkers of inflammation, and oxidative stress in hemodialysis patients. We searched the EMBASE, MEDLINE, Web of Science, and Cochrane Library databases until 8 August 2021. Randomized controlled trials evaluating adult patients receiving hemodialysis were included. The pooled results from 23 studies with 931 hemodialysis patients indicated that interventions significantly decreased the circulating levels of p-cresyl sulfate (standardized mean difference (SMD): 0.38; 95% CI: -0.61, -0.15; = 0.001), endotoxins (SMD: -0.58; 95% CI: -0.99, -0.18; = 0.005), malondialdehyde (SMD: -1.16; 95% CI: -1.81, -0.52; = 0.0004), C-reactive proteins (CRP) (SMD: -0.61; 95% CI: -0.99, -0.23; = 0.002), and interleukin 6 (SMD: -0.92; 95% CI: -1.51, -0.33; = 0.002), and improved the total antioxidant capacity (SMD: 0.89; 95% CI: 0.49, 1.30; < 0.0001) and glutathione (SMD: 0.40; 95% CI: 0.14, 0.66; = 0.003) when compared to the placebo group. Our results suggest that treatment with probiotics, prebiotics, and synbiotics may help alleviate uremic toxin levels, oxidative stress, and the inflammatory status in hemodialysis patients.

肠道微生物群失调可能在终末期肾病患者中引发多种并发症，而补充益生菌、益生元及合生元可能会缓解这些并发症。本系统评价和荟萃分析的目的是评估这些补充剂对血液透析患者循环中的尿毒症毒素、炎症生物标志物及氧化应激的影响。我们检索了截至2021年8月8日的EMBASE、MEDLINE、科学网和考克兰图书馆数据库。纳入了评估接受血液透析的成年患者的随机对照试验。来自23项研究、共931例血液透析患者的汇总结果表明，与安慰剂组相比，干预措施显著降低了对甲酚硫酸盐的循环水平（标准化均数差（SMD）：0.38；95%置信区间：-0.61，-0.15；P = 0.001）、内毒素（SMD：-0.58；95%置信区间：-0.99，-0.18；P = 0.005）、丙二醛（SMD：-1.16；95%置信区间：-1.81，-0.52；P = 0.0004）、C反应蛋白（CRP）（SMD：-0.61；95%置信区间：-0.99，-0.23；P = 0.002）和白细胞介素6（SMD：-0.92；95%置信区间：-1.51，-0.33；P = 0.002），并提高了总抗氧化能力（SMD：0.89；95%置信区间：0.49，1.30；P < 0.0001）和谷胱甘肽水平（SMD：0.40；95%置信区间：0.14，0.66；P = 0.003）。我们的结果表明，使用益生菌、益生元及合生元进行治疗可能有助于减轻血液透析患者的尿毒症毒素水平、氧化应激及炎症状态。