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 pa-tients 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 myocardi-al fibrosis markers[type Ⅰ collagen precursor C-propeptide(PⅠ CP),type Ⅲ collagen precursor N-propeptide(PⅢNP),P Ⅰ CP/PⅢNP,type Ⅰ collagen carboxyl-terminal peptide(Ⅰ CTP)],cardiac function indicators[leftventricular ejection fraction(LVEF),left ventricular end-diastolic di-ameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular end-systolic vol-ume(LVESV)],intestinal flora abundance,plasma trimethylamine oxide(TMAO)levels,and ser-um tumor necrosis factor-α(TNF-α)and interleukin-1 β(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 P Ⅰ CP/PⅢNP in the study group was higher than that in the control group,while the Ⅰ CTP level was lower than that in the control group(P＜0.05).After treatment,the abundances of Proteobacteria,Actinobac-teria,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-1 β 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 ef-fectively reduce myocardial fibrosis in patients with CHF and improve intestinal microecology and prognosis.
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