溃疡性结肠炎患者血清TNF-α、IL-10表达与肠道菌群分布的相关性

Correlation of serum TNF-α,IL-10 expression and intestinal flora distribution in patients with ulcerative colitis

目的观察溃疡性结肠炎(UC)患者肠道菌群分布情况,分析血清肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)水平与肠道菌群的关系,为未来该类疾病临床干预方案的制定提供参考依据。方法回顾性分析2017年1月至2020年6月南京医科大学附属南京医院(南京市第一医院)完成治疗的29例活动期UC患者,作为观察组;并选取同期院内完成治疗的29例缓解期UC患者,作为对照组;对比分析两组血清TNF-α、IL-10表达与肠道菌群分布情况,分析各血清指标与肠道菌群的关系。结果观察组血清TNF-α水平高于对照组,且血清IL-10水平低于对照组,差异有统计学意义(P<0.05);观察组乳杆菌、梭杆菌数量均多于对照组,且双歧杆菌、拟杆菌数量均少于对照组,差异有统计学意义(P<0.05);相关性分析结果显示,血清TNF-α水平与乳杆菌、梭杆菌均呈正相关(r>0,P<0.05),与双歧杆菌、拟杆菌均呈负相关(r<0,P<0.05);血清IL-10水平与乳杆菌、梭杆菌均呈负相关(r<0,P<0.05),与双歧杆菌、拟杆菌均呈正相关(r>0,P<0.05)。结论UC患者普遍存在肠道菌群分布异常的情况,可能与血清TNF-α、IL-10异常表达相关,临床可通过早期持续监测UC患者的血清TNF-α、IL-10水平,以评估其肠道菌群分布情况,指导早期合理干预。

Objective To observe the distribution of intestinal flora in patients with ulcerative colitis(UC),to analyze the relationship between serum tumor necrosis factor-α(TNF-α),interleukin-10(IL-10)levels and intestinal flora,to provide a reference for the development of clinical intervention program for this kind of disease in the future.Methods 29 patients with UC in active stage who completed treatment in Nanjing Hospital Affiliated to Nanjing Medical University(Nanjing First Hospital)from January 2017 to June 2020 were retrospectively analyzed,included into an observation group;and 29 UC patients in remission stage who completed treatment in the same period in the hospital were selected,included into a control group;the expression of serum TNF-αand IL-10 and the distribution of intestinal flora were compared between the two groups,the relationship between serum indexes and intestinal flora was analyzed.Results The serum TNF-αlevel in the observation group was higher than the control group,and the serum IL-10 level was lower than that in the control group,the difference was significant statistically(P<0.05);the number of Lactobacillus and Fusobacterium in the observation group was larger than the control group,and the number of Bifidobacterium,Bacteroides in the observation group was smaller than the control group,the difference was significant statistically(P<0.05);correlation analysis showed that serum TNF-αlevel was positively correlated with Lactobacillus and Fusobacterium(r>0,P<0.05),and was negatively correlated with Bifidobacterium and Bacteroides(r<0,P<0.05);serum IL-10 level was negatively correlated with Lactobacillus and Fusobacterium(r<0,P<0.05),and was positively correlated with Bifidobacterium and Bacteroides(r>0,P<0.05).Conclusion The abnormal distribution of intestinal flora is common in UC patients,which may be related to the abnormal expression of serum TNF-αand IL-10,in order to evaluate the distribution of intestinal flora and guide the early and reasonable intervention,the serum levels of TNF-αand IL-10 in UC patients can be continuously monitored clinically in the early stage.