Effect of oral probiotics on intestinal microecology in patients with chronic heart failure

LI Yunling; ZHANG Yazhou; ZHANG Yunfang; TONG Jing; WANG Weiwei

doi:10.7619/jcmp.20233646

Journal of Clinical Medicine in Practice > 2024 > 28(9): 73-77. > DOI: 10.7619/jcmp.20233646

LI Yunling, ZHANG Yazhou, ZHANG Yunfang, TONG Jing, WANG Weiwei. Effect of oral probiotics on intestinal microecology in patients with chronic heart failure[J]. Journal of Clinical Medicine in Practice, 2024, 28(9): 73-77. DOI: 10.7619/jcmp.20233646

Citation:

PDF (761 KB)

Effect of oral probiotics on intestinal microecology in patients with chronic heart failure

1.
Department of Geriatrics, the Second People's Hospital of Kunming of Yunnan Province, Kunming, Yunnan, 650000
2.
Department of Laboratory Medicine, the Second People's Hospital of Kunming of Yunnan Province, Kunming, Yunnan, 650000
3.
Female Psychiatric Department, Yunnan Mental Hospital, Kunming, Yunnan, 650000
4.
Department of Cardiovascular Medicine, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650000

More Information

Received Date: November 13, 2023
Revised Date: February 27, 2024
Available Online: May 14, 2024

Graphical Abstract

Abstract

Abstract

Objective
To investigate the effect of probiotics in patients with chronic heart failure (CHF) and its impact on intestinal microecology.
Methods
A total of 112 patients with CHF were selected as research subjects and randomly divided into study group and control group, with 56 patients in each group. The control group received angiotensin-converting enzyme inhibitors (ACEI) combined with angiotensin Ⅱ receptor blockers (ARB) for treatment, while the study group received bifidobacterium viable capsules on the basis of treatment in the control group. The levels of myocardial fibrosis markers[type Ⅰ collagen precursor C-propeptide (PⅠCP), type Ⅲ collagen precursor N-propeptide (PⅢNP), PⅠCP/PⅢNP, type Ⅰ collagen carboxyl-terminal peptide (ⅠCTP)], cardiac function indicators[leftventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular end-systolic volume (LVESV)], intestinal flora abundance, plasma trimethylamine oxide (TMAO) levels, and serum tumor necrosis factor-α(TNF-α) and interleukin-1β(IL-1β) levels were measured in both groups. The therapeutic effects, drug safety, re-hospitalization rate, and mortality rate within 3 months after discharge were observed in both groups.
Results
The total effective rate in the study group was 71.43 %, which was higher than 51.79 % in the control group (P < 0.05). After treatment, the LVEF in the study group was higher than that in the control group, while LVEDD, LVESD, and LVESV were lower than those in the control group (P < 0.05). After treatment, the PⅠCP/PⅢNP in the study group was higher than that in the control group, while the ⅠCTP level was lower than that in the control group (P < 0.05). After treatment, the abundances of Proteobacteria, Actinobacteria, Firmicutes, and Fusobacteria in the study group were lower than those in the control group, while the abundance of Bacteroidetes was higher than that in the control group (P < 0.05). After treatment, the levels of TMAO, TNF-α, and IL-1β in the study group were lower than those in the control group (P < 0.05). No serious adverse reactions occurred in either group after treatment. Within 3 months after discharge, the re-hospitalization rate in the study group was 12.50 %, which was lower than 30.36 %in the control group (P < 0.05). The mortality rates in the study group and the control group were 1.79 % and 7.14 %, respectively, but no statistically significant difference was observed(P>0.05).
Conclusion
The combination of probiotics with ACEI and ARB can effectively reduce myocardial fibrosis in patients with CHF and improve intestinal microecology and prognosis.
- probiotics,
- angiotensin converting enzyme inhibitors,
- angiotensin Ⅱ receptor blockers,
- chronic heart failure,
- myocardial fibrosis

FullText(HTML)

References (24)

References

[1]	徐艳, 余敏, 王璐璐. 改良早期预警评分联合超声心动图及血清标志物预测老年慢性心力衰竭病人长期预后的临床价值[J]. 中西医结合心脑血管病杂志, 2022, 20(24): 4572-4576. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYY202224030.htm
[2]	MASCOLO A, MAURO G D, CAPPETTA D, et al. Current and future therapeutic perspective in chronic heart failure[J]. Pharmacol Res, 2022, 175: 106035. doi: 10.1016/j.phrs.2021.106035
[3]	潘东, 蒲丽君, 王伟, 等. 沙库巴曲缬沙坦与培哚普利对改善慢性心力衰竭患者心室重构的对比研究[J]. 实用临床医药杂志, 2021, 25(7): 93-97. doi: 10.7619/jcmp.20201469
[4]	MARTIN N, MANOHARAN K, THOMAS J, et al. Beta-blockers and inhibitors of the renin-angiotensin aldosterone system for chronic heart failure with preserved ejection fraction[J]. Cochrane Database Syst Rev, 2018, 6(6): CD012721.
[5]	KSIAZCZYK M, LELONEK M. Angiotensin receptor/neprilysin inhibitor-a breakthrough in chronic heart failure therapy: summary of subanalysis on PARADIGM-HF trial findings[J]. Heart Fail Rev, 2020, 25(3): 393-402. doi: 10.1007/s10741-019-09879-x
[6]	罗特丹, 周冲冲, 黄鹤鸣. 肠内营养联合双歧杆菌三联活菌对老年慢性心力衰竭病人心功能及微炎症状态的影响[J]. 实用老年医学, 2022, 36(9): 883-887. https://www.cnki.com.cn/Article/CJFDTOTAL-SYLA202209005.htm
[7]	中华医学会心血管病学分会心力衰竭学组, 中国医师协会心力衰竭专业委员会, 中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2018[J]. 中华心力衰竭和心肌病杂志: 中英文, 2018, 2(4): 196-225. https://www.cnki.com.cn/Article/CJFDTOTAL-LCYW201910003.htm
[8]	BREDY C, MINISTERI M, KEMPNY A, et al. New York Heart Association (NYHA) classification in adults with congenital heart disease: relation to objective measures of exercise and outcome[J]. Eur Heart J Qual Care Clin Outcomes, 2018, 4(1): 51-58. doi: 10.1093/ehjqcco/qcx031
[9]	郑筱萸. 中药新药临床研究指导原则: 试行[M]. 北京: 中国医药科技出版社, 2002: 68-73, 77-85.
[10]	任宝燕, 王绥绥. 早期心脏康复策略对急性心肌梗死PCI后患者心功能、日常生活能力的影响[J]. 临床医学研究与实践, 2023, 8(14): 178-181. https://www.cnki.com.cn/Article/CJFDTOTAL-YLYS202314051.htm
[11]	杨晓明, 郑祥, 王超超. 肠道菌群代谢产物与冠心病合并慢性心力衰竭的相关性及对患者预后水平的预测作用[J]. 中华全科医学, 2023, 21(10): 1676-1678, 1718. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY202310011.htm
[12]	詹真皇, 周明君, 李重阳, 等. 慢性心力衰竭患者血清BNP、Copeptin水平与短期不良终点事件的关系[J]. 检验医学与临床, 2023, 20(10): 1447-1450. https://www.cnki.com.cn/Article/CJFDTOTAL-JYYL202310024.htm
[13]	徐欢欢, 薛莉. 沙库巴曲缬沙坦对射血分数保留心力衰竭的影响[J]. 宁夏医科大学学报, 2022, 44(10): 1024-1028. https://www.cnki.com.cn/Article/CJFDTOTAL-XNXY202210011.htm
[14]	翁菲菲, 冯文化, 郭青榜, 等. 老年慢性心力衰竭患者血清新型炎性因子水平与心室重构的关系[J]. 中国临床医生杂志, 2022, 50(3): 294-298. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLYS202203012.htm
[15]	张芳, 陈国藩, 任开涵, 等. 麝香保心丸对老年慢性心力衰竭患者心功能、心室重构及血管内皮因子的影响[J]. 中华全科医学, 2022, 20(12): 2006-2009. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY202212004.htm
[16]	MARTÍNEZ-MILLA J, GARCÍA M C, URQUÍA M T, et al. Blockade of renin-angiotensin-aldosterone system in elderly patients with heart failure and chronic kidney disease: results of a single-center, observational cohort study[J]. Drugs Aging, 2019, 36(12): 1123-1131. doi: 10.1007/s40266-019-00709-1
[17]	张振东, 蔡斌, 王宏伟, 等. 肠道菌群及其代谢产物苯乙酰谷氨酰胺在慢性心力衰竭患者中的变化研究[J]. 中国全科医学, 2023, 26(29): 3665-3673. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX202329010.htm
[18]	邢团结, 娄焕堃, 李鹏, 等. 血清氧化三甲胺水平与冠心病及冠状动脉狭窄程度的相关性分析[J]. 蚌埠医学院学报, 2023, 48(4): 466-469, 473. https://www.cnki.com.cn/Article/CJFDTOTAL-BANG202304011.htm
[19]	MANSURI N M, MANN N K, RIZWAN S, et al. Role of gut microbiome in cardiovascular events: a systematic review[J]. Cureus, 2022, 14(12): e32465.
[20]	王亚楠, 李保. 肠道菌群及其代谢物氧化三甲胺与心肌梗死关系的研究进展[J]. 中西医结合心脑血管病杂志, 2021, 19(24): 4305-4308. doi: 10.12102/j.issn.1672-1349.2021.24.019
[21]	邵良发, 鄢高亮, 张启杰, 等. TMAO通过PI3K/Akt/mTOR通路干预急性心肌梗死病人动脉斑块的作用机制[J]. 中西医结合心脑血管病杂志, 2023, 21(8): 1427-1431, 1436. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYY202308012.htm
[22]	李泽桦, 曾宇宏, 冯丽芸, 等. 氧化三甲胺促进M1型巨噬细胞极化加剧心肌梗死后心室重构[J]. 实用医学杂志, 2022, 38(20): 2531-2537, 2544. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYZ202220005.htm
[23]	陈艳, 许丽丽, 王丽曼, 等. 血浆三甲胺N-氧化物与心肌梗死关系的研究进展[J]. 医药导报, 2023, 42(4): 524-528. https://www.cnki.com.cn/Article/CJFDTOTAL-YYDB202304013.htm
[24]	张月, 杨得振. 急性心肌梗死患者肠道菌群的变化[J]. 检验医学与临床, 2019, 16(14): 1978-1981. https://www.cnki.com.cn/Article/CJFDTOTAL-JYYL201914008.htm

[1]	YAN Shanshan, WANG Ya, YAO Dongfang. Development of a risk prediction model for dialysis disequilibrium syndrome in hemodialysis patients based on decision tree algorithm[J]. Journal of Clinical Medicine in Practice, 2024, 28(18): 51-55, 61. DOI: 10.7619/jcmp.20242224
[2]	CHEN Xiaohui, JIAO Zishan, WANG Nana, SHA Kaihui. Decision tree C5.0 versus Logistic regression model in predicting postpartum diastasis recti abdominis[J]. Journal of Clinical Medicine in Practice, 2023, 27(16): 115-120, 126. DOI: 10.7619/jcmp.20230893
[3]	LU Xiangyue, WANG Yannian, LI Quanzhong. Analysis in performance of GM(1, 1) model in predicting blood glucose at different ranges[J]. Journal of Clinical Medicine in Practice, 2021, 25(9): 23-28, 36. DOI: 10.7619/jcmp.20210757
[4]	WANG Ni, CHEN Yaping, CAO Yundan, TANG Weifen, XIA Qianying. Application of optimized distribution and subarea administration in the transfusion department of out-patient and emergency[J]. Journal of Clinical Medicine in Practice, 2019, 23(18): 125-128. DOI: 10.7619/jcmp.201918036
[5]	ZHANG Ming, YU Fangfang, ZHANG Xiaoxia, CAO Rong, CHU Jianghui. Optimized nursing strategy for thoracic closed drainage and its clinical outcomes[J]. Journal of Clinical Medicine in Practice, 2017, (16): 50-52. DOI: 10.7619/jcmp.201716016
[6]	LI Ying, WANG Rongfang. Clinical efficacy of optimized emergency nursing in rescue of patients with acute myocardial infarction[J]. Journal of Clinical Medicine in Practice, 2017, (4): 8-10. DOI: 10.7619/jcmp.201704003
[7]	LI Yi, LI Haoyue. The influence of optimized emergency nursing procedure on the rescue efficiency of emergency patients[J]. Journal of Clinical Medicine in Practice, 2015, (22): 38-40. DOI: 10.7619/jcmp.201522013
[8]	WANG Man, LI Rong, GU Limei, ZHAO Lingyan, LI Fengxin, GU Moli. Application of optimized nursing procedure in emergency rescue of acute myocardial infarction patients[J]. Journal of Clinical Medicine in Practice, 2015, (8): 9-11,24. DOI: 10.7619/jcmp.201508003
[9]	WANG Jie, XIANG Shuangrong, YANG Hua. Research on effect of optimized nursing model in improving sleep quality and emotional state of patients with congestive heart failure[J]. Journal of Clinical Medicine in Practice, 2014, (10): 10-12. DOI: 10.7619/jcmp.201410004
[10]	CHENG Yan, JI Dan, CHEN Lili. Effect observation of optimized oral nursing on the treatment of children with herpetic stomatitis[J]. Journal of Clinical Medicine in Practice, 2013, (8): 120-121. DOI: 10.7619/jcmp.201308045

Cited By

Cited by

Periodical cited type(2)

1.	张存莉, 张瑛, 吴进, 刘昌奎. 全身奥硝唑给药及局部盐酸米诺环素给药用于牙种植术后的临床效果. 临床医学研究与实践. 2019(13): 18-19 .
2.	叶波阳, 汤自明, 廖仕芬. 牙龈与牙槽嵴修整手术对牙齿修复的影响分析. 中国当代医药. 2018(17): 116-118 .

Other cited types(1)

Get Citation

PDF

XML

Article views (134) PDF downloads (9) Cited by(3)

Turn off MathJax

Article Contents

Abstract

References

Effect of oral probiotics on intestinal microecology in patients with chronic heart failure

Abstract

References

Related Articles

Cited by

Periodical cited type(2)

Other cited types(1)

Catalog

Effect of oral probiotics on intestinal microecology in patients with chronic heart failure

Abstract

References

Related Articles

Cited by

Periodical cited type(2)

Other cited types(1)

Catalog

Export File

Citation

Format

Content