肠道菌群变化与炎症性肠病相关性研究

Correlation between intestinal flora changes and inflammatory bowel disease

目的探讨炎症性肠病(IBD)患者的肠道菌群变化及肠道菌群与炎症性肠病的相关性。方法选取2017年9月~2018年9月入院接受诊疗的120例成人炎症性肠病活动期患者作为本次研究对象,其中溃疡性结肠炎(UC)患者75例,克罗恩病(CD)45例,另选择50例健康查体者作为对照组。采集各组新鲜粪便,使用梯度稀释法定量培养肠道菌群;采用全自动血液分析仪检验血液标本的C反应蛋白和白细胞计数。结果UC组和CD组粪便样本中大肠杆菌、肠球菌、拟杆菌数量均高于对照组(P<0.05),UC组和CD组粪便样本中双歧杆菌、乳酸杆菌、柔嫩梭菌数量均低于对照组(P<0.05),UC组粪便样本中的柔嫩梭菌数量高于CD组(P<0.05),UC组粪便样本中的拟杆菌数量低于CD组(P<0.05);UC组和CD组C反应蛋白和白细胞计数均高于对照组(P<0.05),UC组和CD组各炎症指标相比无统计学差异(P>0.05);UC组肠道炎症反应的发生与大肠杆菌、肠球菌和双歧杆菌存在相关性。结论与健康人群相比,IBD活动期患者的肠道菌群呈失衡状态,菌群的改变与炎症性肠病存在一定程度的相关性,这为炎症性肠病的临床治疗提供方向。

Objective To investigate the changes of intestinal flora and the relationship between intestinal flora and inflammatory bowel disease in patients with inflammatory bowel disease(IBD).Methods A total of 120 adult patients with inflammatory bowel disease who were admitted to the hospital from September 2017 to September 2018 were enrolled in this study.Among them,there were 75 patients with ulcerative colitis(UC)and 45 cases with Crohn's disease(CD).50 healthy subjects were selected as the control group.Fresh feces were collected from each group,and the intestinal flora was quantitatively cultured by gradient dilution method.C-reactive protein and white blood cell counts of blood samples were examined using a fully automated blood analyzer.Results The numbers of Escherichia coli,Enterococcus and Bacteroides in the stool samples of UC group and CD group were higher than those of the control group(P<0.05).The numbers of Bifidobacteria,Lactobacillus and Clostridium leptumin the stool samples of UC group and CD group were lower than those in the control group(P<0.05).Clostridium leptum in the stool samples of the UC group was higher than that of the CD group(P<0.05),and the number of the Bacteroidaceae in the stool samples of the UC group was lower than that of the CD group(P<0.05).The C-reactive protein and white blood cell counts in the UC group and CD group were higher than those in the control group(P<0.05).There was no significant difference in inflammatory indexes between the UC group and the CD group(P>0.05).The intestinal inflammation occurred in the UC group.There was a correlation between the occurrence of intestinal inflammation with Escherichia coli,Enterococcus and Bifidobacteria.Conclusion Compared with that of healthy people,the intestinal flora of patients with active IBD is unbalanced,and the change of flora has a certain degree of correlation with inflammatory bowel disease,which provides direction for the clinical treatment of inflammatory bowel disease.