活动期与缓解期溃疡性结肠炎患者黏膜主要菌群研究

Quantitative research of the main mucosa-associated microbiota in patients with active and remissional ulceraive colitis

目的 比较活动期与缓解期溃疡性结肠炎（UC）之间的黏膜微生态（MAM）.方法 收集21例正常对照、41例活动期UC和9例缓解期UC的结、直肠黏膜.采用实时定量聚合酶链反应（Real-time PCR）检测MAM主要菌群的数量.结果 与健康对照比较,UC黏膜总菌数无显著改变.球形梭菌（C.coccoides）、普拉梭菌在（F.prausnitzii）活动、缓解期UC结肠和直肠溃疡中显著减少（8％比22％,10％比22％,10％比22％,10％比22％,P＜0.05;4％比13％,7％比13％,4％比13％,4％比13％,P＜0.05）.柔嫩梭菌（C.leptum）在活动、缓解期结肠溃疡,活动期直肠溃疡与非溃疡中显著减少（9％比22％,11％比22％,9％比22％,16％比22％,P＜0.05）.大肠杆菌（E.coli）在活动、缓解期结肠溃疡以及活动期直肠溃疡与非溃疡中显著增加（21％比6％,21％比6％,P＜0.05;11％比6％,21％比6％,P＜0.05）.缓解期结肠C.leptum显著高于活动期结肠（11％比9％,P ＜0.05）,缓解期直肠普氏菌属（Prevotella）数量显著高于活动期直肠（2％比0％,P＜0.01）.结论 活动与缓解期UC的MAM与健康对照不同,活动与缓解期之间黏膜主要菌群差异无统计学意义;MAM益生菌的减少及条件致病菌的增多,提示它们可能参与UC的发病与炎症的维持.

Objective To investigate the characteristics of the main mucosa-associated microbiota （MAM） in active and remissional ulcerative colitis （UC） patients.Methods We collected the mucosal specimens from 21 healthy controls （HC）,41 active UC （AUC） and 9 remissional UC （RUC） patients,respectively.The DNA samples were analyzed by quantitative real-time polymerase chain recation （Real-time PCR） targeting 16S rRNA gene of intestinal bacterium.Results There were significant difference in the total bacteria between AUC and RUC with healthy controls.C.coccoides,and F.prausnitzii markedly decreased in the ulcer of colon （U-colon-AUC,U-colon-RUC） and rectum （U-rectum-AUC,U-rectum-RUC） in patients with AUC and RUC （8% vs.22%,10% vs.22%,10% vs.22%,10% vs.22%,P〈0.05;4% vs.13%,7% vs.13%,4% vs.13%,4% vs.13%,P 〈 0.05）.C.leptum decreased greatly in the U-colon-AUC,U-colon-RUC,U-rectum-AUC and non-ulcer ofrectum-AUC （NU-rectum-AUC） （9% vs.22%,11% vs.22%,9% vs.22%,16% vs.22%,P 〈0.05）.E.coli increased significantly in the U-colon-AUC,U-colon-RUC,U-rectum-AUC and NU-rectum-AUC （21% vs.6%,21% vs.6%,P〈0.05;11% vs.6%,21% vs.6%,P〈0.05）.C.leptum of the U-colon-AUC was lower than U-colon-RUC markedly （9% vs.11%,P 〈 0.05）,and Prevotella of the U-rectum-AUC was lower than U-rectum-RUC greatly （2% vs.0%,P 〈 0.01）.Conclusion The major composition of MAM in patients with AUC and RUC differs from that of HC,but there was no significant difference between the active and the remissional UC patients except C.leptum and Prevotella.Decrease of probiotics and increase of opportunistic pathogens in MAM of patients with UC indicated that they might be associated with the occurrence and the progress of UC.