轮状病毒感染腹泻患儿肠道菌群分布及外周血TLRs表达水平及意义

Distribution of intestinal flora and expressions of TLRs in peripheral blood of children with rotavirus infection-induced diarrhea and their significance

目的 研究轮状病毒(RV)感染腹泻患儿肠道菌群分布和外周血Toll样受体(TLRs)表达水平及其临床意义。方法 选取2019年6月-2022年6月中国医科大学附属盛京医院RV感染腹泻患儿147例为研究对象,根据病程和Vesikari量表评分对患儿进行分组,并于入院第1天和治疗第7天时采集血液和粪便样本,采用荧光定量聚合酶链反应(PCR)技术进行肠道菌群定量分析,同时检测TLR1~10 mRNA表达量,比较RV感染腹泻患儿不同病程、严重程度和治疗前后肠道菌群分布及外周血TLR1~10 mRNA表达水平。结果 与病程<7 d或Vesikari量表评分<9分相比,病程≥7 d和Vesikari量表评分≥9分患儿肠道乳酸杆菌、双歧杆菌、拟杆菌和梭菌属数量降低,外周血TLR2、TLR3、TLR4、TLR7、TLR8和TLR9 mRNA表达量升高,差异有统计学意义(P<0.05);RV腹泻患儿治疗第7天肠道乳酸杆菌、双歧杆菌、拟杆菌属和梭菌属数量升高,外周血TLR2、TLR3、TLR4、TLR7、TLR8和TLR9 mRNA表达量降低,差异有统计学意义(P<0.05)。结论 RV感染腹泻患儿肠道菌群中乳酸杆菌、双歧杆菌、拟杆菌属和梭菌属数量减少,同时外周血TLRs表达水平升高,且与病程、病情严重程度以及疗效均存在密切联系。

OBJECTIVE To explore the distribution of intestinal flora in children with rotavirus(RV) infection-induced diarrhea, expression levels of Toll-like receptors(TLRs) in peripheral blood and analyze the clinical significance. METHODS A total of 147 children with RV infection-induced diarrhea who were treated in Shengjing Hospital of Chine Medical University from Jun 2019 to Ju 2022 were recruited as the research subjects and were grouped according to the course of disease and score of Vesikari scale. The blood and stool samples were collected on the 1st day of admission and the seventh 7th day of treatment, the quantitative analysis of intestinal flora was performed by fluorescent quantitative polymerase chain reaction(PCR), the relative expression levels of TLR1-10 mRNA were detected. The distribution of intestinal flora and expression levels of peripheral blood TLR1-10 mRNA were observed and compared among the RV infection-induced diarrhea children with different courses of diseases, severities or before and after the treatment. RESULTS The counts of intestinal Lactobacillus, Bifidobacterium, Bacteroides and Clostridium of the children with course of disease no less than 7 days and Vesikari scale score no less than 9 points were less than those of the children with course of disease less than 7 days or Vesikari scale socre less than 9 points. The expression levels of peripheral blood TLR2, TLR3, TLR4, TLR7, TLR8 and TLR9 mRNA of the children with course of disease no less than 7 days and Vesikari scale score no less than 9 points were significantly higher than those of the children with course of disease less than 7 days or Vesikari scale socre less than 9 points(P<0.05). The counts of intestinal Lactobacillus, Bifidobacterium, Bacteroides and Clostridium of the children with RV infection-induced diarrhea were increased on the 7th day of treatment, the relative expression levels of peripheral blood TLR2, TLR3, TLR4, TLR7, TLR8 and TLR9 mRNA were reduced, and there were significant differences(P<0.05). CONCLUSION The counts of intestinal flora Lactobacillus, Bifidobacterium, Bacteroides and Clostridium of the children with RV infection-induced diarrhea are reduced, the expression levels of peripheral blood TLRs are elevated, which is closely associated with the course of disease, severity and curative effect.