接受程序化血液透析患者的结肠微生物群落及其纠正。

Colon Microbiocenosis and Its Correction in Patients Receiving Programmed Hemodialysis.

机构信息

Leading Researcher, Laboratory of Human Microbiome and Means of Its Correction; Academician I.N. Blokhina Nizhny Novgorod Scientific Research Institute of Epidemiology and Microbiology of Rospotrebnadzor (Russian Federal Consumer Rights Protection and Human Health Control Service), 71 Malaya Yamskaya St., Nizhny Novgorod, 603950, Russia.

Associate Professor, Department of Nervous Diseases; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia.

出版信息

Sovrem Tekhnologii Med. 2021;12(5):62-68. doi: 10.17691/stm2020.12.5.07. Epub 2020 Oct 28.

DOI:10.17691/stm2020.12.5.07

PMID:34796006

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8596268/

Abstract

UNLABELLED

was to study the species composition of colon microbiocenosis in patients with chronic kidney disease receiving programmed hemodialysis treatment and to evaluate the efficacy of its correction using a new immobilized synbiotic.

MATERIALS AND METHODS

Samples of colon microbiota from 62 patients undergoing programmed hemodialysis were studied before and after a course of diet therapy that included probiotic components, in particular, the immobilized synbiotic LB-complex L. Isolation of microorganisms was carried out according to our original method; for bacteria identification, a MALDI-TOF Autoflex speed mass spectrometer (Bruker Daltonik, Germany) was used in the Biotyper program mode. The results were assessed using the criteria proposed by the authors and based on the OST 91500.11.0004-2003. The efficacy of the immobilized synbiotic was determined based on the clinical data, questionnaires, and bacteriological tests.

RESULTS

In patients receiving programmed hemodialysis (before the start of the diet therapy), chronic moderate inflammation and azotemia were found. Dysbiotic changes in microbiocenosis were revealed in all the examined patients; in the absence or suppression of lacto- and bifidoflora, the number and diversity of , , , and other bacteria increased, which was consistent with the theory of functional redundancy of gut microbiota. From the answers to the questionnaires, a decrease in the quality of life was found (up to 70 points out of 100) according to six of the eight scales used. After the combined therapy using the synbiotic LB-complex L in the study group, 56% of the examined patients showed their microbiocenosis restored to normal; no grade III dysbiosis was detected in any patient. There was a significant decrease in CRP and ESR in these patients and an improvement in the quality of life by criteria reflecting physical health.

CONCLUSION

In patients receiving programmed hemodialysis, the addition of a probiotic component in the diet therapy restores the evolutionarily determined structure of the microbiocenosis, normalizes its functions, and leads to an overall improvement in health and quality of life.

摘要

目的

研究接受程序化血液透析治疗的慢性肾脏病患者结肠微生物群落的物种组成，并评估使用新型固定化共生体进行校正的疗效。

材料和方法

研究了 62 名接受程序化血液透析的患者在接受包括益生菌成分在内的饮食治疗前后的结肠微生物群样本，特别是固定化共生体 LB-complex L。根据我们的原始方法进行微生物分离；使用 MALDI-TOF Autoflex speed 质谱仪（德国 Bruker Daltonik）在 Biotyper 程序模式下进行细菌鉴定。使用作者提出的标准和基于 OST 91500.11.0004-2003 的标准进行评估。根据临床数据、问卷调查和细菌学测试来确定固定化共生体的疗效。

结果

在接受程序化血液透析的患者（在开始饮食治疗之前）中，发现存在慢性中度炎症和氮血症。所有检查的患者都显示出微生物群落的生态失调变化；在缺乏或抑制乳杆菌和双歧杆菌的情况下，数量和多样性增加，和其他细菌，这与肠道微生物群的功能冗余理论一致。根据使用的八个量表中的六个量表，从问卷答案中发现生活质量下降（100 分中最多 70 分）。在研究组中使用共生体 LB-complex L 进行联合治疗后，56%的检查患者显示其微生物群落恢复正常；任何患者均未检测到 III 级生态失调。这些患者的 CRP 和 ESR 显著下降，反映身体健康的标准的生活质量得到改善。