小剂量利福昔明改善内毒素血症的肝硬化患者的前瞻性研究

StephenW

Does low-dose rifaximin ameliorate endotoxemia in patients with liver cirrhosis: A prospective study

    Xin Zeng1,†, Xia-Jiao Tang1,†, Xia Sheng1,†, Wu Ni2, Hai-Guang Xin2, Wei-Zhong Chen1, Cai-Feng Jiang1, Yong Lin1, Jian Shi1, Bin Shi1, Yue-Xiang Chen1, Zong-Li Yuan1 andWei-Fen Xie1,*

DOI: 10.1111/1751-2980.12294

This article is protected by copyright. All rights reserved.

    1    Department of Gastroenterology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
    2    Department of Infectious Disease, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China

    †    These authors contributed equally to this work.

*Correspondence to: Wei-Fen Xie, Department of Gastroenterology, Shanghai Changzheng Hospital, 415 Fengyang Road, Shanghai 200003, China. Email: [email protected]

    This study was supported by the Science and Technology guiding plan of Shanghai (124119a0702)

    This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/cdd.12294.


Keywords:

    rifaximin;endotoxin;liver cirrhosis

BACKGROUND

Rifaximin therapy could improve gut-derived endotoxin in patients with liver cirrhosis. However, the experience of long-term rifaximin administration in Chinese population is limited.
AIM

To evaluate the efficacy, safety and tolerability of different doses of rifaximin in Chinese patients with hepatic cirrhosis.
METHODS

The random open prospective study included a 2-week treatment period and the next 4-week observation phase. Patients with liver cirrhosis were randomly assigned to low-dose rifaximin group, high-dose rifaximin group, and control group in a 1:1:1 ratio. Patients in low-dose and high-dose rifaximin group received 400 mg, 600 mg rifaximin two times a day for two weeks, respectively. All the other therapeutic strategies remained unchanged in the three groups as far as possible.
RESULTS

Sixty patients with liver cirrhosis were screened and 43 met the eligibility. After 2 weeks treatment, the serum level of endotoxin in low-dose rifaximin group (1.1 ± 0.8EU/ml) and high-dose rifaximin group (1.0 ± 0.8EU/ml) was significantly lower than that in control group (2.5 ± 1.8EU/ml), while no difference was shown between the two rifaximin treatment groups. The effect of high-dose rifaximin on endotoxemia could lasted to at least 4 weeks after drug withdrawal. A significant reduction in the abundance of the taxa Veillonellaceae and increase in the abundance of Bacteroides were shown after two weeks rifaximin therapy. The incidence of adverse events and serious adverse events was similar in the three groups.
CONCLUSIONS

Our findings indicated low-dose (800 mg/d) rifaximin could be analogous to high-dose (1200 mg/d) rifaximin to reduce the serum endotoxin level after two-weeks treatment. This article is protected by copyright. All rights reserved.

StephenW

难道小剂量利福昔明改善内毒素血症的肝硬化患者的前瞻性研究

    鑫Zeng1，†，夏娇Tang1，†，夏Sheng1，†，吴NI2，海广欣2，魏忠臣1，彩凤Jiang1，永琳，建Shi1，宾Shi1，悦翔臣1，宗 - 李媛andWei芬Xie1，*

DOI：10.1111 / 1751-2980.12294

这篇文章是受版权保护的。版权所有。

    消化内科，上海长征医院，第二军医大学，上海，中国1系
    传染病，上海长征医院，第二军医大学，上海，中国2部

    †这些作者同等贡献这项工作。

*通讯作者：魏奋谢，消化内科，上海长征医院，凤阳路415，上海200003，中国。电子邮件：[email protected]

    这项研究是由上海的科技指导性计划的支持（124119a0702）

    这篇文章已被接受发表，并经过充分的同行评审，但经过审稿，排版，分页和校对过程中，这可能会导致这个版本和记录的版本之间的差异还没有。请引用这篇文章的DOI：10.1111 / cdd.12294。


关键词：

    利福昔明;内毒素;肝硬化

背景

利福昔明治疗可改善肝硬化患者肠源性内毒素。然而，长期给予利福昔明在中国人的经历是有限的。
AIM

为了评估中国的肝硬化患者的疗效，安全性和不同剂量的利福昔明的耐受性。
方法

随机开放的前瞻性研究包括2周的治疗期和接下来的4周的观察期。肝硬化病人被随机分配到低剂量的利福昔明基，高剂量的利福昔明组和对照组中的1：1：1的比例。在低剂量和高剂量的利福昔明组患者接受400毫克，分别为600毫克的利福昔明，每天两次，两周。所有其他的治疗策略中的三组保持不变尽可能。
结果

60例肝硬化患者进行了筛选，43遇到的资格。经过2周的治疗，内毒素低剂量利福昔明组的血清水平（1.1±0.8EU / ml）和高剂量组利福昔明（1.0±0.8EU /毫升）明显低于对照组（2.5±1.8显著降低EU /毫升），而没有差异两个利福昔明治疗组之间所示。高剂量的利福昔明对内毒素血症的影响停药后可以持续到至少4周。一个显著降低的类群Veillonellaceae和增加杆菌丰丰两周后利福昔明治疗被证明。不良事件和严重不良事件的发生率，在三组相似。
结论

我们的研究结果表明低剂量（800毫克/天），利福昔明可能是类似于大剂量（1200毫克/天），利福昔明，以减少之后两个星期的治疗血清内毒素水平。这篇文章是受版权保护的。版权所有。

llau_lhf

肠源性内毒素?象江湖郎中的字眼。