脓毒症患者血浆内毒素水平及肠道菌群变化分析

Analysis the plasma endotoxin levels and intestinal flora changes in patients with sepsis

目的探讨脓毒症患者肠道菌群变化情况,分析脓毒症严重程度与内毒素水平及肠道菌群失调之间的相关性。方法收集2015年1月至2017年12月陕西中医药大学第二附属医院重症医学科收治的脓毒症患者90例为观察组,分为脓毒症组、严重脓毒症组和脓毒症休克组,每组30例。另选取同期健康志愿者30例为对照组。血中内毒素水平和粪便菌群作为检测指标。结果观察组血液中内毒素均为阳性,且内毒素水平随着病情的加重而增高,均显著高于对照组(P<0.05);观察组的肠道菌群失调率显著高于对照组(P<0.05);内毒素水平、肠道菌群失调情况与脓毒症的严重程度有一定的相关性。结论脓毒症患者病情的严重程度与内毒素水平升高、肠道菌群紊乱呈正相关。

Objective To investigate the changes of intestinal flora in patients with sepsis, and the correlation betweenthe severity of sepsis and endotoxin levels and intestinal flora imbalance. Methods From January 2015 to December 2017, 90patients with sepsis admitted in the ICU of the Second Affiliated Hospital of Shaanxi University of Chinese Medicine wereselected as observation group, and these patients were divided into sepsis group, severe sepsis group and septic shock grouprespectively, with 30 cases in each group. Another 30 healthy volunteers were selected as reference group at the same period.Blood endotoxin levels and fecal flora were used as indicators of detection. Results The endotoxin in the blood of theobservation group was positive, and the endotoxin level increased with the aggravation of the disease, which was significantlyhigher than the control group （P〈0.05）. The intestinal flora imbalance rate of the observation group was significantly higherthan that of the control group （P〈0.05）. Endotoxin levels, intestinal flora imbalance and the severity of sepsis had a certaincorrelation. Conclusion The severity of the disease in patients with sepsis is positively correlated with increased levels ofendotoxin and intestinal flora imbalance.