Effect of probiotics on hemodynamic changes and complications associated with cirrhosis:A pilot randomized controlled trial
作者机构：Department of Internal MedicineGastroenterology and HepatologySechenov UniversityMoscow 119435Russia The Scientific Community for Human Microbiome ResearchMoscow 119435Russia Consultative and Diagnostic Center No.2 of Moscow Health DepartmentMoscow 107764Russia
出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)
年 卷 期：2022年第14卷第8期
页 面：1667-1677页
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
基 金：Supported by Biocodex Microbiota Foundation:National Research Grant Russia 2019
主 题：Gut Gut-liver axis Microbiota Hemodynamics Heart Gut-heart axis Saccharomyces boulardii Portal hypertension
摘 要：BACKGROUND Bacterial translocation exacerbates the hyperdynamic circulation observed in cirrhosis and contributes to a more severe disease *** may reduce bacterial translocation and may therefore be useful to redress the circulatory *** To investigate the effect of probiotics on hemodynamic parameters,systemic inflammation,and complications of cirrhosis in this randomized placebocontrolled *** This single-blind randomized placebo-controlled study included 40 patients with Child-Pugh class B and C cirrhosis;24 patients received probiotics(Saccharomyces boulardii)for 3 mo,and 16 patients received a placebo over the same *** function and the systemic hemodynamic status were evaluated pre-and *** and simultaneous blood pressure and heart rate monitoring were performed to evaluate systemic hemodynamic *** output and systemic vascular resistance were *** Following a 3-mo course of probiotics in comparison to the control group,we observed amelioration of hyperdynamic circulation[a decrease in cardiac output(P=0.026)and an increase in systemic vascular resistance(P=0.026)]and systemic inflammation[a decrease in serum C-reactive protein levels(P=0.044)],with improved liver function[an increase in serum albumin(P=0.001)and a decrease in the value of Child-Pugh score(P=0.001)]as well as a reduction in the severity of ascites(P=0.022),hepatic encephalopathy(P=0.048),and cholestasis[a decrease in serum alkaline phosphatase(P=0.016)and serum gamma-glutamyl transpeptidase(P=0.039)activity]and an increase in platelet counts(P0.001)and serum sodium level(P=0.048).CONCLUSION Probiotic administration was associated with amelioration of hyperdynamic circulation and the associated complications of cirrhosis.
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