儿童功能性便秘患者肠道菌群及血清脑肠肽水平的变化

Changes of intestinal flora and brain-gut peptides in children with functional constipation

目的探讨儿童功能性便秘(FC)患者肠道菌群及血清脑肠肽水平的变化。方法选取2017年1月至2019年4月在我院儿科门诊治疗的80例FC患儿为研究组,选择同期于体检中心检查的无胃肠道疾病的30例健康儿童为健康组。研究组患儿根据病情轻重分为轻中度组(52例)和重度组(28例)。比较各组儿童肠道菌群数量[乳杆菌、双歧杆菌和大肠埃希菌]及血清脑肠肽指标[一氧化氮(NO)、P物质(SP)和血管活性肠肽(VIP)]水平的差异。结果研究组患儿肠道双歧杆菌[(8.16±0.89)lg CFU/g]和乳杆菌数量[(7.92±0.83)lg CFU/g]明显少于健康组[(8.94±0.97)lg CFU/g、(8.63±0.91)lg CFU/g],而大肠埃希菌数量[(8.12±0.81)lg CFU/g]明显多于健康组[(7.30±0.72)lg CFU/g],差异有统计学意义(t=2.37、2.35、2.44,P<0.05)。重度组患儿肠道双歧杆菌和乳杆菌数量明显少于轻中度组,而大肠埃希菌数量明显多于轻中度组(t=2.36、2.34、2.29,P<0.05)。研究组患儿血清NO和VIP水平[(50.12±8.25)μmol/L、(29.17±5.12)pg/mL]明显高于健康组[(34.46±6.13)μmol/L、(20.43±4.79)pg/mL],SP水平[(5.21±0.82)ng/mL]明显低于健康组[(7.57±1.04)ng/mL],差异有统计学意义(t=2.78、2.54、2.47,P<0.05)。重度组患儿血清NO和VIP水平高于轻中度组,SP水平明显低于轻中度组(t=2.31、2.41、2.23,P<0.05)。结论 FC患儿存在肠道菌群失调和脑肠肽分泌异常,且随着病情的加重其肠道菌群失调及脑肠肽分泌异常越发明显。

Objective To observe the changes of intestinal flora and level of brain-gut peptides in children with functional constipation(FC). Methods A total of 50 children with FC(research group) who were treated in the outpatient department of pediatrics and 30 healthy children without gastrointestinal diseases(health group) receiving physical exam during the same period were enrolled. The children in research group were divided into mild/moderate group(52 cases) or severe group(28 cases) according to the severity of their disease. The differences in number of intestinal flora(Lactobacilli, Bifidobacteria and E.coli) and serum brain-gut peptide indexes [nitric oxide(NO), P substance(SP) and vasoactive intestinal peptide(VIP) ] were compared between research group and health group, and between severe group and mild/moderate group. Results The number of Bifidobacteria [(8.16±0.89) lg CFU/g and Lactobacilli [(7.92±0.83) lg CFU/g] in research group was lower, while the number of E.coli [(8.12±0.81) lg CFU/g] was higher than that in health group respectively. The number of Bifidobacteria and Lactobacilli in severe group was lower, while the number of E.coli was higher than that in mild/moderate group(P<0.05) respectively. The levels of serum NO [(50.12±8.25) μmol/L] and VIP [(29.17±5.12) pg/mL] in research group were higher(all P<0.05), while the level of SP [(5.21±0.82) ng/mL] was lower than that in health group respectively. The levels of serum NO and VIP in severe group were higher(t=2.31, 2.23;P<0.05), while the level of SP was lower than that in mild/moderate group(t=2.41;P<0.05) respectively. Conclusion Children with FC have intestinal flora imbalance and abnormal secretion of brain-gut peptides, which tend to be more obvious along with the disease exacerbation.