ABSTRACT
Objective:To observe the changes of serum micro-inflammatory and nutritional status in elderly peritoneal dialysis patients after treatment with bifidobacterium triple viable bacteria, and the impact of Bifidobacterium triple viable bacteria treatment on the endpoint.Methods:Totally 180 elderly patients receiving peritoneal dialysis were divided into control group and observation group, with 90 cases in each.Both groups were treated on the basis of the routine treatment, the observation group was treated with oral Bifidobacterium triple viable bacteria for twelve months.Before treatment, 6 months and 12 months after treatment, fasting venous blood from the patients in the two groups were collected in the morning.The levels of serum micro-inflammatory indexes[tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), interleukin-8(IL-8), C-reactive protein(CRP)]were detected by ELISA.The nutritional status and dialysis adequacy indexes[nutritional status: albumin(ALB), hemoglobin(Hb), transferrin(TRF), prealbumin(PA), calcium ion, phosphorus ion; indicators of dialysis adequacy: serum creatinine(Scr), blood uric acid(BUA), blood urea nitrogen(BUN), cystatin C(Cys-c)levels]were detected by automatic blood biochemical analyzer.After 24 months of follow-up, the occurrence of endpoint events(peritonitis, abdominal pain, malnutrition, abdominal infection, cardiovascular and cerebrovascular accidents)in the two groups was recorded.Results:After 24 months of treatment, the levels of TNF-α, IL-6, IL-8 and CRP in the two groups were lower than those before treatment, and the observation group was lower than control group[(25.7±4.0)μg/L vs.(33.6±6.0)μg/L, (2.9±0.7)ng/L vs.(4.9±1.2)ng/L, (17.0±7.2)ng/L vs.(22.8±7.9)ng/L, (4.6±0.7)mg/L vs.(6.9±1.2)mg/L]( t=10.272, 13.134, 5.040, 15.575, respectively, P<0.05 for all). After 24 months of treatment, the levels of ALB, Hb, TRF, PA and calcium ion of the two groups were higher than before treatment, and the levels of phosphorus ion were lower than before treatment, and the changes of the above indicators in observation group were more obvious than those in the control group[(45.7±5.2)g/L vs.(39.8±4.9)g/L, (72.7±8.0)g/L vs.(68.6±9.0)g/L, (4.3±1.0)g/L vs.(3.0±0.6)g/L, (321.5±29.0)mg/L vs.(297.6±25.1)mg/L, (4.9±1.3)mmol/L vs.(2.9±0.9)mmol/L, (1.3±0.9)/L vs.(1.8±0.3 mmol/L)]( t=7.737, 3.213, 9.880, 5.9 00, 11.937, 4.415, P<0.05 for all). There was no significant difference in intestinal flora between the two groups before treatment( P>0.05). After 24 months, an increase was observed in Lactobacilli and Bifidobacteria in both groups, while Enterobacteria and Enterococcus in both groups were decreased, and the changes of the above indicators in the observation group were also more obvious than those in the control group[(8.4±0.9)IgCFU/g ratio(6.4±0.9)IgCFU/g, (8.8±1.3)IgCFU/g ratio(7.9±1.3)IgCFU/g, (7.1±0.9)IgCFU/g ratio(8.0±1.1)IgCFU/g, (5.4±0.7)IgCFU/g ratio(6.9±0.9)IgCFU/g]( t=14.248, 4.339, 5.825, 12.753, P<0.05 for all). There was no significant difference in dialysis adequacy index between the two groups before treatment( P>0.05 for all). After 24 months of treatment, the levels of Scr, BUA, BUN and Cys-C in both groups decreased, and those of the observation group were lower than those of the control group[(471.5±50.5)μmol/L vs.(623.3±62.6)μmol/L, (17.5±0.5)mmol/L vs.(20.6±1.8)mmol/L, (16.4 ± 3.0)mmol/L vs.(22.5±2.0)mmol/L, (1.9±0.5)mg/L vs.(3.0±0.7)mg/L]( t=17.877, 14.976, 15.842, 11.749, P<0.05 for all). The incidence of endpoint events in the observation group was significantly lower than that in the control group(12.2% vs.2.2%, t=6.574, P<0.05 for all). Conclusions:After the treatment of Bifidobacterium triple viable bacteria in elderly peritoneal dialysis patients, the micro-inflammatory state of the patients was reduced, the nutritional status was improved, and the incidence of endpoint events was low, and has high clinical promotion and application value.