尿毒症患者肠道菌群失调与微炎症状态的关系

Relationship exploration between the dysbacteriosis and micro-inflammation of patients with uremia

目的研究尿毒症患者肠道菌群失调与微炎症状态之间的关系。方法将本院收治的90例尿毒症患者根据是否采用血液透析治疗分为透析组及无透析组,每组各45例。同时选取45例健康者作为健康组。检测三组研究对象超敏C反应蛋白(hs-CRP)及粪便中双歧杆菌、嗜酸乳杆菌、大肠杆菌及粪肠球菌的浓度,并分析尿毒症患者肠道菌群浓度变化与hs-CRP间的关系。结果透析组及无透析组患者hs-CRP、大肠杆菌及粪肠球菌浓度均明显高于健康组(P<0.01),双歧杆菌及嗜酸乳杆菌浓度均明显低于健康组(P<0.01),但透析组及无透析组患者4种细菌检测浓度比较无明显差异(P>0.05);以hs-CRP浓度作为因变量,菌群浓度作为自变量进行逐步回归分析,结果显示,嗜酸乳杆菌及粪肠球菌浓度变化对hs-CRP浓度具有明显影响(P<0.05)。结论尿毒症患者中普遍存在肠道菌群失调及微炎症状态,双歧杆菌及嗜酸乳杆菌浓度降低,大肠杆菌及粪肠球菌浓度升高;尿毒症患者肠道内嗜酸乳杆菌及粪肠球菌浓度改变可能影响微炎症状态;血液透析对肠道菌群及微炎症状态无明显影响。

Objective To explore the relationship between the dysbacteriosis and micro-inflammation of patients with uremia. Method 90 cases uremia patients were divided into hematodialysis group and nonhematodialysis group according to whether to adopt hemodialysi, and 45 cases healthy people were selected as health group. Tested the concentration of high-sensitivity C-reactive protein（hs-CRP）, bifidobacterium longum, lactobacillus acidophilus, escherichia coli and enterococcus faecalis in the three groups. ResultBoth of hematodialysis group and non-hematodialysis group had obviously higher concentration of hs-CRP escherichia coli and enterococcus faecalis than health group（P〈0.01）; hematodialysis group and nonhematodialysis group both had lower concentration of bifidobacterium longum and lactobacillus acidophilus than health group（P〈0.01）. There were no significant differences of bifidobacterium longum, lactobacillus acidophilus, escherichia coli and enterococcus faecalis between hematodialysis group and non-hematodialysis group（P〉0.05）. Stepwise regression analysis was applied when concentration of hs-CRP was selected as dependent variable and concentration of bacteria was selected as independent variable. Results showed that the changes in the concentration of lactobacillus acidophilus and enterococcus faecalis had significantly affected the concentration of hs-CRP（P〈0.05）. Conclusion It is ubiquitous of dysbacteriosis and microinflammation in patients with uremia. Concentration of bifidobacterium longum and lactobacillus acidophilus in uremia patients are decreased and concentration of escherichia coli and enterococcus faecalis are rising. The changes in the concentration of lactobacillus acidophilus may affect micro-inflammation. Hematodialysis has no effect on micro-inflammation and dysbacteriosis.