2026 年第 3 期 第 21 卷

双歧杆菌四联活菌片对老年男性重症肺炎患者肠道菌群和血清叉头框蛋白O3及自噬相关基因7与巨噬细胞炎症蛋白-3α水平的影响

Effect of Bifidobacterium quadruple live tablets on intestinal flora, serum forkhead box O3, autophagy-related gene 7 and macrophage inflammatory protein-3α levels in elderly male patients with severe pneumonia

作者：张宏唐静怡胡阳孙辉

英文作者：Zhang Hong Tang Jingyi Hu Yang Sun Hui

单位：中国人民解放军联勤保障部队第九八〇医院干部病房科，石家庄050082

英文单位：Department of Cadre Ward the 980th Hospital of the Joint Logistics Support Force of the Chinese People′s Liberation Army Shijiazhuang 050082 China

关键词：老年重症肺炎；双歧杆菌四联活菌片；肠道菌群；叉头框蛋白O3；自噬相关基因7；巨噬细胞炎症蛋白-3α

英文关键词：Elderlyseverepneumonia;Bifidobacteriumquadruplelivetablets;Intestinalflora;ForkheadboxO3;Autophagy-relatedgene7;Macrophageinflammatoryprotein-3α

• 摘要：

• 目的 探究双歧杆菌四联活菌片对老年男性重症肺炎患者肠道菌群和血清叉头框蛋白O3（FOXO3）、自噬相关基因7（ATG7）、巨噬细胞炎症蛋白-3α（MIP-3α）水平的影响。方法 选取2023年2月至2024年8月中国人民解放军联勤保障部队第九八〇医院收治的80例老年男性重症肺炎患者为研究对象。按照随机数字表法分为对照组和观察组，每组40例。对照组患者接受营养支持、吸氧、祛痰等常规治疗，观察组在对照组基础上给予双歧杆菌四联活菌片治疗。2组患者均连续治疗2周。比较2组患者的临床疗效、症状好转时间、免疫功能、炎症因子、肠道菌群。结果 观察组治疗总有效率高于对照组［95.0%（38/40）比77.5%（31/40）］，差异有统计学意义（χ2=5.165，P=0.023）。观察组患者临床症状好转时间均短于对照组，差异均有统计学意义（均P＜0.05）。治疗后，2组患者CD+3、CD+4和CD+4/CD+8比值水平均高于治疗前，且观察组均高于对照组，差异均有统计学意义（均P＜0.05）。治疗后，2组患者降钙素原、C反应蛋白、血清淀粉样蛋白A、肺表面活性蛋白、FOXO3、ATG7、MIP-3α水平均低于治疗前，且观察组均低于对照组，差异均有统计学意义（均P＜0.05）。治疗后，观察组患者乳酸杆菌、双歧杆菌菌落数量均高于治疗前，肠球菌菌落数量低于治疗前；观察组乳酸杆菌、双歧杆菌菌落数量均高于对照组，肠球菌菌落数量低于对照组，差异均有统计学意义（均P＜0.05）。结论 双歧杆菌四联活菌片治疗老年重症肺炎患者可以显著提高临床效果，降低患者炎症水平，改善肠道菌群。

• Objective To investigate the effect of Bifidobacterium quadruple live tablets on intestinal flora and the serum levels of forkhead box O3 (FOXO3), autophagy-related gene 7 (ATG7), and macrophage inflammatory protein-3α (MIP-3α) in elderly male patients with severe pneumonia. Methods A total of 80 elderly male patients with severe pneumonia admitted to the 980th Hospital of the Joint Logistics Support Force of the Chinese People′s Liberation Army from February 2023 to August 2024 were selected as research subjects. They were divided into a control group and an observation group using the random number table method, with 40 cases in each group. The control group received conventional treatments such as nutritional support, oxygen inhalation, and expectoration. The observation group was given Bifidobacterium quadruple live tablets on the basis of the control group. Both groups were treated continuously for 2 weeks. The clinical efficacy, symptom improvement time, immune function, inflammatory factors, and intestinal flora were compared between the two groups. Results The total effective rate of treatment in the observation group was higher than that in the control group ［95.0%(38/40) vs 77.5%(31/40)］(χ2=5.165, P=0.023). The times to clinical symptom improvement in the observation group were shorter than those in the control group (all P＜0.05). After treatment, the levels of CD+3, CD+4, and CD+4/CD+8 ratio in both groups were higher than those before treatment, and the observation group had significantly higher levels than the control group (all P＜0.05). After treatment, the levels of procalcitonin, C-reactive protein, serum amyloid A, surfactant protein, FOXO3, ATG7, and MIP-3α in both groups were lower than those before treatment, and the observation group had significantly lower levels than the control group (all P＜0.05). After treatment, the levels of Lactobacillus and Bifidobacterium in the observation group were higher than those before treatment, while Enterococcus was lower than that before treatment; the levels of Lactobacillus and Bifidobacterium in the observation group were higher than those in the control group, and Enterococcus was lower than that in the control group (all P＜0.05). Conclusion Bifidobacterium quadruple live tablets can significantly improve the clinical efficacy, reduce the inflammatory level, and modulate the intestinal flora in elderly patients with severe pneumonia.