溃疡性结肠炎患者肠道菌群与血TNF-α、内毒素水平的关系

Study on correlation of characteristics of intestinal flora with serum levels of TNF-α and endotoxin in paients with ulcerative colitis

目的探讨溃疡性结肠炎(UC)患者肠道菌群特点及血中肿瘤坏死因子(TNF)-α、内毒素含量变化,为UC治疗和病情评估提供依据。方法选取确诊的57例UC患者,其中缓解期28例,活动期29例,10例健康体检者作对照。运用可培养细菌菌群分析方法,对每例受试者粪便进行分析;清晨空腹抽血酶联免疫吸附(ELISA)法测TNF-α含量,采用鲎试剂三肽显色基质偶氮法测内毒素水平。结果 UC活动期组与缓解期组、对照组比较乳酸杆菌数量明显减少,差异显著(P<0.01);双岐菌UC缓解期组数量少于对照组(P<0.05),活动期组数量明显减少,与缓解期组、对照组比较均具有显著性差异(P<0.01);UC活动期组内毒素水平明显升高,与缓解期组、对照组比较均具有显著性差异(P<0.01);UC活动期组TNF-α水平明显升高,与缓解期组、对照组比较均具有显著性差异(P<0.01);乳酸杆菌数量与血桨内毒素水平、血清TNF-α含量均呈负相关(r=-0.860、-1.038,P<0.01);双岐菌数量与血桨内毒素水平、血清TNF-α含量均呈负相关(r=-0.932、-0.843,P<0.01)。结论 UC患者存在菌群失调;测定UC患者血TNF-α、内毒素水平有益于评估病情。

Objective To explore the correlation of characteristics of intestinal flora with serum levels of TN - α and endotoxin in patients with ulcerative colitis. Methods Fifty - seven patients diagnosed as ulcerative colitis including 28 patients at remission stage （ remission group） and 29 patients at active stage （ active group）. Ten healthy persons were selected as control group. Selective culture mediums were used for counting the amount of bacteria. The serum levels of TNF - α and endotoxin were determined in every patient of 2 groups. Results The amount of Laetobaeillii and Bifidobacteria in patients of active group was significantly lower than that of patients in remission group and control group （ all P 〈0. 01 ）. The serum levels of TNF - α and endotoxin in patients of active group were significantly higher than those of patients in remission group and control group （ P 〈0.01 ）. Negative correlation was found between the amount of Lactobacillii and serum levels of TNF -α and endotoxin （ r = - 0. 860, - 1. 038 ; P 〈 0.01 ）, and negative correlation was observed between the amount of Bifidobacterla and serum levels of TNF - α and endotoxin （ r = - 0. 932, - 0. 843 ; P 〈 0. 01 ）. Conclusion The disorder in intestinal flora can be found in patients with ulcerative colitis. It is beneficial for determining serum levels of TNF - ctand endotoxin to evaluate the severity of disease in patients with ulcerative colitis. There is significant correlation between intestinal flora and serum levels of TNF - α and endotoxin in patients with ulcerative colitis.