果聚糖对儿童肠易激综合征临床症状和炎症因子的影响研究

Effect of fructan on clinical symptoms and inflammatory cytokines of irritable bowel syndrome in children

目的探讨饮食中的果聚糖是否会加重儿童肠易激综合征(IBS)的症状和对外周血清炎症因子的影响.方法2018年1月~2019年10月,选取江宁医院儿科招募的230例IBS亚型患儿,通过双盲对照交叉试验,受试者被随机分配到含有果聚糖或麦芽糊精的72 h低聚糖、双糖、单糖和多元醇(fermentable oligosaccharides,disaccharides and monosaccharides and polyols,FODMAP)膳食组内,试验期间,受试者在其监护人指导下完成腹部症状和大便日记记录,试验前后分别抽取受试者外周血检测炎症因子水平.结果果聚糖组疼痛频率、严重程度、腹胀和每天大便次数等临床症状评分显著高于麦芽糊精组(P<0.05);果聚糖组外周血清中r-干扰素(interferon-r,IFN-r、白介素-6(interleukin-6,IL-6)、白介素-8(interleukin-8,IL-8)、白介素-10(interleukin-10,IL-10)和白介素-18(interleukin-18,IL-18)等炎症因子水平显著高于麦芽糊精组(P<0.05);患儿果聚糖敏感发生率为52.09%,果聚糖敏感组在临床症状评分和炎症因子指标等方面均显著高于果聚糖不敏感组(P<0.05).结论果聚糖可加重IBS患儿的腹痛、腹胀等多种临床症状,导致外周血清炎症因子升高,果聚糖对果聚糖敏感型的IBS患儿影响程度更大.

Objective To explore whether fructan in diet exacerbates the symptoms of irritable bowel syndrome(IBS)in children and its effect on inflammatory cytokines in peripheral serum.Methods A total of 230 children who were recruited by the Affiliated Jiangning Hospital of Nanjing Medical University from January 2018 to October 2019 and diagnosed with subtype of IBS were involved in a double-blind controlled cross-over trial,in which,all the children were randomly divided into group A(low fermentable oligosaccharides,disaccharides and monosaccharides and polyols[FODMAP]diet containing fructan,72h)and group B(low FODAMP die containing maltodextrin,72h).During the trial,the subject completed the logbook for abdominal symptoms and stool under the guidance of their guardians.Blood samples were collected before and after the trial to detect the levels of inflammatory cytokines in peripheral serum.Results The scores of clinical symptoms,including frequency and severity of pain,abdominal distension and number of bowel movements per day,in group A were significantly higher than that in group B(P<0.05).The levels of interferon-γ(IFN-γ),interleukin-6(IL-6),interleukin-8(IL-8),interleukin-10(IL-10),interleukin-18(IL-18)and other inflammatory cytokines in group A were significantly higher than that in group B(P<0.05).Fructan-sensitive subjects accounted for 52.09%.The scores of clinical symptoms and levels of inflammatory cytokines in fructan-sensitive subjects were significantly higher than that in fructan-insensitive subjects(P<0.05).Conclusion Fructan may exacerbate the abdominal pain,abdominal distention and other clinical symptoms in children with IBS,resulting in the increase of levels of inflammatory cytokines in peripheral serum.It has a greater effect on fructan-sensitive children with IBS.