幼儿过敏性肠道疾病与肠道黏膜屏障及短链脂肪酸的相关性研究

Study on relationship between allergic intestinal diseases and intestinal mucosal barrier and short-chain fatty acids in children

目的探讨幼儿过敏性肠道疾病与肠道黏膜屏障、短链脂肪酸的相关性。方法选用2018年6月至2020年6月巩义市人民医院收治的过敏性肠道疾病患儿80例作观察组,行胃镜检查,以黏膜性质分为观察组A(胃肠黏膜异常,n=49例)及观察组B(胃肠黏膜正常,n=31例),同期选用未患过敏性肠道疾病患儿80例作对照组,比较两组肠道黏膜屏障指标、粪便细菌数量与双歧杆菌/大肠杆菌(B/E)数量比及短链脂肪酸水平。结果观察组免疫调节蛋白(sIgA)水平均低于对照组,乳果糖(L%)、甘露醇(M%)及尿乳果糖/甘露醇比值(L/M)均高于对照组,差异均具有统计学意义(P<0.05);观察组A sIgA水平较之观察组B更低、L%、M%及L/M较之观察组B更高,差异均具有统计学意义(P<0.05);观察组双歧杆菌数量及B/E数量比均低于对照组,大肠杆菌数量均高于对照组,差异均具有统计学意义(P<0.05);观察组A双歧杆菌数量及B/E数量比较之观察组B更低,大肠杆菌数量较之观察组B更高,差异均具有统计学意义(P<0.05);观察组乙酸、丙酸、丁酸水平均高于对照组,异丁酸水平低于对照组,差异均具有统计学意义(P<0.05)。结论幼儿过敏性肠道疾病普遍肠道黏膜屏障功能异常,且短链脂肪酸水平下降明显,而明确疾病致病机理,可从肠道菌群及代谢产物为切入点进行针对性有效治疗。

Objective To investigate the correlation between allergic intestinal diseases and intestinal mucosal barrier and short-chain fatty acids in children.Methods From June 2018 to June 2020 totally 80 case with allergic bowel disease in our hospital as observation group, line gastroscopy to mucous membrane properties were divided into group A(abnormal gastrointestinal mucosa, n=49 cases) and group B(normal gastric mucosa, n=31 cases), at the same time choose not allergic children with intestinal disease 80 cases as control group, comparing two groups of intestinal mucosa barrier index, fecal bacteria number and number of B/E ratio and short chain fatty acid level.Results BsIgA levels in the observation group, observation group A and observation group were all lower than those of the control group, and L%, M% and L/M were all higher than those of the control group, with statistically significant differences(P<0.05). AsIgA level in the observation group was lower than that of the observation group B, L%, M% and L/M were higher than that of the observation group B, and the differences were statistically significant(P<0.05). The number of bifidobacteria and the number of B/E in the observation group, observation group A and observation group B were all lower than the control group, and the number of Escherichia coli were all higher than the control group, with statistically significant differences(P<0.05). The number of bifidobacteria and B/E in observation group A was lower than that of observation group B, and the number of E. coli was higher than that of observation group B, and the difference was statistically significant(P<0.05). The levels of acetic acid, propionic acid and butyric acid in the observation group were all higher than those of the control group, and the isobutyric acid levels were lower than those of the control group, with statistically significant differences(P<0.05).Conclusion Children with allergic intestinal diseases generally have abnormal intestinal mucosal barrier function, and the level of short-chain fatty acid is significantly decreased. To clarify the pathogenic mechanism of the disease, targeted and effective treatment can be conducted from the perspective of intestinal flora and metabolites.