布拉酵母菌联合熊去氧胆酸及蓝光光疗对胎龄≥35周新生儿肝内胆汁淤积症的疗效分析

摘要/Abstract

摘要： 目的探讨布拉酵母菌联合熊去氧胆酸及蓝光光疗对胎龄≥35周新生儿肝内胆汁淤积症的临床疗效。方法选取2021年1月至2024年1月榆林市星元医院接收的92名胎龄≥35周新生儿肝内胆汁淤积症患儿为研究对象。通过随机数字表法分为对照组(n=46,熊去氧胆酸+蓝光光疗)和布拉酵母菌组(n=46,在对照组基础上给予布拉酵母菌治疗)。比较两组患儿的临床疗效、治疗前后的肝功能指标、肠道菌群分布、炎症水平、肝脾大小以及黄疸指数。结果治疗后,布拉酵母菌组的治疗总有效率达到89.13%(41/46),高于对照组的71.74%(33/46)(P<0.05)。治疗后,布拉酵母菌组的TBil为(81.20±17.13)μmol/L,DBil为(65.42±12.44)μmol/L,TBA为(75.19±16.88)U/L,分别低于对照组的(91.88±18.69)μmol/L、(73.88±13.59)μmol/L、(88.09±24.10)U/L(P＜0.05)。布拉酵母菌组的双歧杆菌为(8.64±0.63)lg CFU/g、乳酸杆菌为(8.75±0.66)lg CFU/g,均高于对照组的(7.97±0.55)lg CFU/g、(8.22±0.71)lg CFU/g。布拉酵母菌组的大肠杆菌为(6.37±0.58)lg CFU/g,低于对照组的(6.85±0.69)lg CFU/g(P＜0.05)。布拉酵母菌组的hs-CRP为(0.57±0.22)mg/L,IL-6为(32.17±4.92)ng/L,TNF-α为(214.27±31.82)ng/L,分别低于对照组的(1.37±0.43)mg/L、(38.52±5.19)ng/L、TNF-α(242.48±33.95)ng/L(P＜0.05)。布拉酵母菌组的肝脏大小为(2.39±0.37)cm、脾脏大小为(0.67±0.10)cm,黄疸指数为(11.12±4.96)mg/dL,分别低于对照组的(2.65±0.39)cm、(0.74±0.13)cm与(15.36±4.41)mg/dL(P＜0.05)。结论布拉酵母菌联合熊去氧胆酸及蓝光光疗可有效改善胎龄≥35周肝内胆汁淤积症新生儿肝功能和肠道菌群分布,降低炎症水平,值得在临床上进一步推广应用。

关键词: 肝内胆汁淤积症, 布拉酵母菌, 熊去氧胆酸, 蓝光光疗, 新生儿

Abstract: Objective To investigate the clinical efficacy of Saccharomyces boulardii in combination with ursodeoxycholic acid and blue light phototherapy on neonatal intrahepatic cholestasis in infants aged ≥35 weeks. Methods From January 2021 to January 2024, 92 infants with intrahepatic cholestasis aged ≥35 weeks were recruited at Xingyuan Hospital in Yulin City. Using a random number table method, they were divided into a reference group (n=46, treated with ursodeoxycholic acid and blue light phototherapy) and a Saccharomyces boulardii group (n=46, treated with the reference group's regimen plus Saccharomyces boulardii). Clinical efficacy, liver function markers, intestinal flora distribution, inflammation levels, liver and spleen size, and jaundice index were compared between the two groups before and after treatment. Results After treatment, the total effectiveness rate in the Saccharomyces boulardii group reached 89.13% (41/46), which was significantly higher than 71.74% (33/46) in the reference group (P<0.05). Post-treatment, the Saccharomyces boulardii group showed lower levels of TBil (81.20±17.13) μmol/L, DBil (65.42±12.44) μmol/L, and TBA (75.19±16.88) U/L compared to the reference group's TBil (91.88±18.69) μmol/L, DBil (73.88±13.59) μmol/L, and TBA (88.09±24.10) U/L (P<0.05). The levels of bifidobacteria (8.64±0.63) lg CFU/g and lactobacilli (8.75±0.66) lg CFU/g were higher, while levels of E. coli (6.37±0.58) lg CFU/g were lower compared to the reference group (P<0.05). Additionally, the Saccharomyces boulardii group exhibited lower hs-CRP (0.57±0.22) mg/L, IL-6 (32.17±4.92) ng/L, and TNF-α (214.27±31.82) ng/L levels than the reference group (P<0.05). Liver span (2.39±0.37) cm, spleen span (0.67±0.10) cm, and jaundice indices (11.12±4.96) mg/dL were also significantly lower than those in the reference group (P<0.05). Conclusion The combination of saccharomyces boulardii, ursodeoxycholic acid, and blue light phototherapy significantly enhances liver function, optimizes intestinal flora, and reduces inflammation in neonates aged 35 weeks and above, suggesting its potential for expanded clinical use.

Key words: Intrahepatic cholestasis, Saccharomyces boulardii, Ursodeoxycholic acid, Blue light phototherapy, Neonate

常亚娜, 贾阳. 布拉酵母菌联合熊去氧胆酸及蓝光光疗对胎龄≥35周新生儿肝内胆汁淤积症的疗效分析[J]. 肝脏, 2025, 30(10): 1414-1418.

CHANG Ya-na, JIA Yang. Analysis of the efficacy of saccharomyces boulardii combined with ursodeoxycholic acid and blue light phototherapy in treating cholestasis in neonates aged 35 weeks and above[J]. Chinese Hepatolgy, 2025, 30(10): 1414-1418.

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