Hida M, Aiba Y, Sawamura S, Suzuki N, Satoh T, Koga Y
Department of Transplantation (Kidney Center), Tokai University School of Medicine, Kanagawa, Japan.
Nephron. 1996;74(2):349-55. doi: 10.1159/000189334.
The plasma levels of phenol, p-cresol, and indican are markedly increased in uremic patients, and cannot be efficiently reduced by hemodialysis. Such uremic toxins, which are produced in the intestine as bacterial putrefactive metabolites, accumulate to a great degree in the feces of hemodialysis patients. Oral administration of Lebenin, a preparation consisting of antibiotic-resistant lactic acid bacteria, reduced the levels of fecal putrefactive metabolites to levels comparable with those of healthy subjects. Moreover, the plasma level of indican also significantly decreased in these Lebenin-treated patients. An analysis of the fecal microflora revealed that a disturbed composition of the microflora characterized by an overgrowth of aerobic bacteria is restored to normal by oral administration of Lebenin in hemodialysis patients. These results thus demonstrate that oral administration of lactic acid bacteria in uremic patients is effective in reducing the levels of uremic toxins, especially that of indican, in the blood by inhibiting bacterial production by means of correcting the intestinal microflora.
尿毒症患者血浆中苯酚、对甲酚和吲哚苷的水平显著升高，且血液透析无法有效降低这些水平。这类作为细菌腐败代谢产物在肠道中产生的尿毒症毒素，在血液透析患者的粪便中大量蓄积。口服由耐抗生素乳酸菌制成的乐贝宁制剂，可将粪便腐败代谢产物的水平降低至与健康受试者相当的水平。此外，在这些接受乐贝宁治疗的患者中，吲哚苷的血浆水平也显著下降。对粪便微生物群的分析表明，口服乐贝宁可使血液透析患者以需氧菌过度生长为特征的微生物群紊乱组成恢复正常。因此，这些结果表明，尿毒症患者口服乳酸菌可通过纠正肠道微生物群来抑制细菌产生，从而有效降低血液中尿毒症毒素的水平，尤其是吲哚苷的水平。
