活动期与缓解期炎症性肠病患者粪便主要菌群差异分析

Quantitative Analysis of the Main Faecal Microbiota in Patients with Active and Remissional Inflammatory Bowel Disease

目的:研究活动期与缓解期炎症性肠病(IBD)患者粪便主要菌群的改变。方法:收集29例正常对照(HC)、41例活动期克罗恩病(CD)(ACD)、53例缓解期CD(RCD)、60例活动期溃疡性结肠炎(UC)(AUC)以及20例缓解期UC(RUC)患者的粪便标本。采用实时定量PCR检测粪便主要菌群的数量。结果:健康对照粪便总菌数量与IBD患者无差异。与正常对照相比,球形梭菌亚群、柔嫩梭菌亚群及普拉梭菌在活动期CD、缓解期CD及活动期UC患者粪便中显著下降(9%、12%、10%vs 23%,P<0.01;9%、16%、11%vs 23%,P<0.05;2%、6%、4%vs 13%,P<0.05);活泼瘤胃球菌在活动期CD与UC中显著增加(2%vs 0,P<0.001;2%vs 0,P<0.01);大肠杆菌在活动期CD、缓解期CD及活动期UC患者粪便中均显著增加(19%、10%、15%vs 4%,P<0.01)。除普拉梭菌外,其他主要菌群在活动期与缓解期IBD间差异无统计学意义。结论:IBD患者粪便主要菌群与健康对照不同;除普拉梭菌外,活动期与缓解期IBD患者粪便主要菌群差异无统计学意义;球形梭菌亚群、柔嫩梭菌亚群及普拉梭菌的减少以及大肠杆菌的增加,提示它们可能参与IBD的发病与肠炎的维持。

Objective： To investigate the changes of the main fecal bacteria in active and remissional inflammatory bowel disease （IBD） patients. Methods： We collected the fecal specimens from 29 healthy controls （HC）, 41 active Crohn＇ s disease patients （ACD）, 53 remissional Crohn ＇s disease （RCD）, 60 active ulcerative colitis patients （AUC） and 20 remissional ulcerative colitis （RUC）, respectively. The DNA samples were analyzed by quantitative real-time polymerase chain reaction（Q-PCR） targeting 16S rRNA gene of intestinal bacterium. Results： Total bacteria were no significant difference as CD and UC were compared with healthy controls in fecal microbiota. Clostridium coccoides , Clostridium leptum , and Faecalibacterium prausnitzii markedly decreased in ACD and AUC, and also markedly decreased in RCD in comparison to HC （9% ,12%, 10% vs23%, P〈0.01; 9%,16%,11% vs23%, P%0.05; 2%,6%,4% vs 13%, P〈0.05, respectively）. R. gnavus was significantly increased in ACD and AUC （2% vs 0%,P〈0.01; 1% vs 0%, P〈0. 05）. E. coli was also significantly increased in ACD, AUC and RCD （19%,10%, 15% vs 4% ,P〈0.01）. The major flora were not significant different between the patients with active IBD and remissional IBD except Faecalibacterium prausnitzii. Conclusion： The major composition of fecal microbiota in IBD patients differs from that of HC, but there were no significant difference between the active and the remissional IBD patients except Faecalibacterium prausnitzii. Decrease of Clostridium coccoides, Clostridium lepturn, and Faecalibacterium prausnitzii and increase of E. coli indicated that they might be associated with the occurrence and the progress of IBD.