脑卒中后便秘患者肠道菌群与炎症水平的相关性研究

Study on the relationship between intestinal flora and inflammation in patients with constipation after stroke

目的探讨缺血性脑卒中便秘患者肠道菌群和体内炎症水平的变化情况。方法纳入2016年12月~2017年12月在成都西部战区总医院神经内科治疗的首发缺血性脑卒中伴便秘患者40例为观察组,按照年龄、性别配对后选择缺血性脑卒中无便秘患者40名作为对照组,收集纳入者粪便和血浆样本。结果观察组患者肠道菌群qPCR检测结果发现肠道拟杆菌(Bacteriodes)和瘤胃球菌科(Ruminococcacea)丰度明显高于对照组(P<0.05);普雷沃氏菌属(Prevotella)丰度观察组较对照组低(P<0.05);革兰氏阴性细菌大肠埃希菌(Escherichia)丰度观察组较对照组高(P<0.05);观察组患者血清TNF-α和IL-1β水平高于对照组(P<0.05)。观察组肠道Lachnospiraceae丰度同血清IL-6水平呈显著负相关(r=-0.35,P<0.05),肠道Ruminococcacea丰度同血清TNF-α水平呈显著负相关(r=-0.48,P<0.05),肠道Escherichia丰度同TNF-α和IL-1β呈正相关(r=0.42,P<0.05;r=0.34,P<0.05)。结论缺血性脑卒中便秘患者肠道菌群组成发生明显改变,同体内炎症水平密切相关。

Objective To explore the changes of intestinal flora and inflammation in patients with constipation after ischemic stroke. Methods From December 2016 to December 2017, 40 patients with constipation in the first ischemic stroke treated in the Department of Neurology of Chengdu western theater general hospital were included as the observation group. After age and gender matching, 40 patients without constipation in the ischemic stroke group were selected as the control group, and feces and plasma samples were collected. Results The results of qPCR showed that the abundance of Bacteroides and ruminococcea in the observation group was significantly higher than that in the control group(P<0.05). The abundance of Prevotella in the observation group was lower than that in the control group(P<0.05). The abundance of Escherichia coli in the observation group was higher than that in the control group(P<0.05). The levels of TNF α and IL 1 β in the observation group were higher than those in the control group(P<0.05). There was a significant negative correlation between the abundance of lachnospiraceae and the level of serum IL 6 in the observation group(r=-0.35, P<0.05). There was a significant negative correlation between the abundance of ruminocacea and the level of TNF α in serum(r=-0.48, P<0.05). The abundance of Escherichia was positively correlated with TNF α and IL 1 β(r=0.42, P<0.05, r=0.34, P<0.05). Conclusion The composition of intestinal flora in patients with constipation after ischemic stroke changed significantly, which was closely related to the level of inflammation in the body.