Department of Minimally invasive intervention, Shandong Provincial Third Hospital, Shandong University, No.11 Wuyingshan Middle Road, Tianqiao District, Jinan, Shandong 250031, PR China.
Department of Gastrointestinal surgery, Shandong Provincial Third Hospital, Shandong University, No.11 Wuyingshan Middle Road, Tianqiao District, Jinan, Shandong 250031, PR China.
Clin Res Hepatol Gastroenterol. 2024 Jun;48(6):102361. doi: 10.1016/j.clinre.2024.102361. Epub 2024 May 1.
There are many options for the reduction of portal hypertension (pH) in cirrhotic patients, but all the current ones have side effects. Probiotics are a new approach for ameliorating the hyperdynamic circulation of cirrhotic patients. The aim of this study is to measure the effect of probiotics on pH in cirrhosis for the first time.
A search was conducted across four electronic databases (PubMed, Scopus, Web of Science, Cochrane) for English-language records evaluating probiotic effects on pH in cirrhotic patients. Quality assessment used the Cochrane Collaboration's tool, employing a random-effects model in statistical analysis with Stata software version 1.
A search yielded 1,251 articles, which were narrowed down to 5 through screening. These studies, involving 158 participants across Canada, India, Spain, and Russia, focused on probiotic interventions in cirrhotic patients. Meta-analysis of two RCTs (66 participants) indicated a significant decrease in hepatic venous pressure gradient (HVPG) (SMD: -0.60 [-1.09, -0.12]). In single-arm analysis, four studies (58 participants) showed a substantial reduction in HVPG with probiotic use compared to the control (SMD: -2.55 [-3.42, -1.68]).
In summary, it showcased a notable reduction in HVPG compared to the control group, indicating a potential advantage of probiotics in decreasing pH in cirrhotic patients. Further research with larger samples and robust designs is warranted.
在肝硬化患者中，有许多降低门静脉高压（pH）的方法，但目前所有方法都有副作用。益生菌是改善肝硬化患者高动力循环的新方法。本研究旨在首次测量益生菌对肝硬化 pH 的影响。
在四个电子数据库（PubMed、Scopus、Web of Science、Cochrane）中进行了英语文献检索，评估益生菌对肝硬化患者 pH 的影响。质量评估采用 Cochrane 协作工具，在 Stata 软件版本 1 中进行统计分析时使用随机效应模型。
搜索产生了 1251 篇文章，通过筛选将其缩小到 5 篇。这些研究涉及加拿大、印度、西班牙和俄罗斯的 158 名参与者，重点是益生菌干预肝硬化患者。两项 RCT（66 名参与者）的荟萃分析表明，肝静脉压力梯度（HVPG）显著降低（SMD：-0.60 [-1.09，-0.12]）。在单臂分析中，四项研究（58 名参与者）表明与对照组相比，益生菌使用后 HVPG 大幅降低（SMD：-2.55 [-3.42，-1.68]）。
综上所述，与对照组相比，HVPG 明显降低，表明益生菌在降低肝硬化患者 pH 方面具有潜在优势。需要进一步进行样本量更大、设计更稳健的研究。
