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Effect of probiotics on hemodynamic changes and complications associated with cirrhosis:A pilot randomized controlled trial

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World Journal of Hepatology 2022年第8期14卷 1667-1677页

作者： Roman Maslennikov Irina Efremova Vladimir Ivashkin Maria Zharkova Elena Poluektova Elena Shirokova Konstantin Ivashkin Department of Internal Medicine Gastroenterology and HepatologySechenov UniversityMoscow 119435Russia The Scientific Community for Human Microbiome Research Moscow 119435Russia Consultative and Diagnostic Center No.2 of Moscow Health Department Moscow 107764Russia

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(P<0.001)and serum sodium level(P=0.048).CONCLUSION Probiotic administration was associated with amelioration of hyperdynamic circulation and the associated complications of cirrhosis.

关键词： gut gut-liver axis Microbiota Hemodynamics heart gut-heart axis Saccharomyces boulardii Portal hypertension

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