艰难梭菌感染与炎症性肠病的关系研究

Correlation between Clostridium difficile infection and inflammatory bowel disease

目的研究艰难梭菌(CDR)感染与炎症性肠病(IBD)发生、发展的相关性,为临床治疗IBD提供参考。方法选择2015年5月-10月于医院就诊58例IBD患者设为观察组,另选同期42名健康体检人员为对照组;采用两步酶免夹心法以及终点荧光检测两组CDR,并分析观察组不同临床症状患者CDR感染率及其相关性。结果观察组58例IBD患者中8例发生CDR感染,占13.79%;观察组患有克罗恩病、疾病为活动期、初发型以及累及结肠患者CDR感染率分别为28.57%、20.00%、37.50%、21.88%,显著高于患有溃疡型结肠炎、疾病为缓解期、非初发型以及累及非结肠患者的5.41%、0.00%、10.00%、3.85%,差异均有统计学意义(P<0.05);Pearson相关性分析显示,患有克罗恩病、疾病为活动期、初发型以及累及结肠型IBD患者均分别与CDR感染呈正相关(r=0.684、0.781、0.703、0.639;均P<0.05)。结论患者发生CDR感染与IBD的发生、发展密切相关。

OBJECTIVE To study the relationship between the Clostridium difficile infection and the occurrence and development of inflammatory bowel disease（IBD）so as to provide guidance for clinical treatment of IBD.METHODS A total of 58 patients with IBD who were treated in the hospital from May 2015 to Oct 2015 were chosen as the observation group,meanwhile,42 healthy people who underwent the physical examination were set as the control group.The C.difficile was detected for the two groups by using two-step ELISA sandwich method and end point fluorescence,the incidence of C.difficileinfection in the patients with different clinical symptoms was analyzed,and the correlation was observed.RESULTS Of the 58 patients with IBD in the observation group,8had the C.difficileinfection,accounting for 13.79%.The incidence rate of C.difficileinfection was 28.57%in the patients with Crohn＇s disease,20.00%in the patients with the disease in active period,37.50%in the patients with initial onset of disease,21.88%in the patients with colon involvement,significantly higher than 5.41%in the patients with ulcerative colitis,0.00%in the patients with the disease in remission stage,10.00%in the patients with non-initial onset of disease,3.85%in the patients with non-colon involvement,and there was significant difference（P〈0.05）.The Pearson correlation analysis indicated that the C.difficileinfection in the patients with IBD was positively correlated with Crohn＇s disease,disease in active stage,initial onset of disease,and colon involvement（r=0.684,0.781,0.703,0.639;all P〈0.05）.CONCLUSION The incidence of C.difficileinfection is closely associated with the occurrence and development of IBD.