肠易激综合征患者肠道灌洗液菌群特点

Characteristics of microbiota in intestinal lavage fluid in patients with irritable bowel syndrome

目的探讨肠易激综合征(IBS)患者肠道灌洗液菌群特点及其临床意义。方法选择2018年10月至2019年10月我院收治的87例肠易激综合征患者为病例组,选择同期我院健康体检者87例为对照组,比较两组对象肠道灌洗液菌群分布,比较不同类型及不同严重程度肠易激综合征患者肠道灌洗液菌群失调情况。采用Spearman相关分析肠易激综合征患者肠道灌洗液菌群失调与疾病类型、症状严重程度的相关性。结果病例组患者肠道乳杆菌、双歧杆菌、双歧杆菌与肠杆菌数量之比(B/E值)显著低于对照组(t=8.097、8.370、8.255,均P<0.001),而肠球菌、肠杆菌数量显著高于对照组(t=11.577、8.424,均P<0.001)。不同类型肠易激综合征患者I度、Ⅲ度肠道灌洗液菌群失调比例差异具有统计学意义(t=30.548、19.145,均P<0.001),而不同类型肠易激综合征患者Ⅱ度肠道灌洗液菌群失调比例差异无统计学意义(t=2.435,P=0.296)。不同严重程度肠易激综合征患者Ⅰ度、Ⅲ度肠道灌洗液菌群失调比例差异有统计学意义(t=8.460、14.872,均P<0.001),而不同严重程度肠易激综合征患者Ⅱ度肠道灌洗液菌群失调比例差异无统计学意义(t=0.923,P=0.631)。肠易激综合征患者肠道灌洗液菌群失调与疾病类型、症状严重程度具有显著相关性(r=0.452、0.586,均P<0.001)。结论肠易激综合征患者存在肠道灌洗液菌群失调情况,不同疾病类型及症状严重程度的患者肠道灌洗液菌群失调情况存在明显差异,临床可根据其肠道灌洗液菌群变化情况给予针对性治疗。

Objective To explore the characteristics and clinical significance of microbiota in intestinal lavage fluid in patients with irritable bowel syndrome(IBS).Methods A total of 87 IBS patients(case group)and 87 healthy individuals(control group)in our hospital from October 2018 to October 2019 were enrolled.The distribution of flora in intestinal lavage fluid was compared between groups,and among patients with different IBS types and different severity degrees.Spearman correlation was used to analyze the correlation between flora imbalance and the type of disease and severity of symptoms in patients with IBS.Results The proportions of Lactobacillus and Bifidobacterium,and ratio of Bifidobacterium to Enterobacter(B/E)in the case group were significantly lower than those in the control group(t=8.097,8.370,8.255;all P<0.001)respectively.The counts of Enterococcus and Enterobacteriaceae in the case group were significantly higher than in the control group respectively(t=11.577,8.424;all P<0.001).The proportions of degreesⅠandⅢintestinal dysbiosis had significant differences among IBS patients with different types(t=30.548,19.145;all P<0.001),while no significant difference was found in degreeⅡ(t=2.435,P=0.296).The proportions of degreesⅠandⅢintestinal dysbiosis had significant differences among IBS patients with different severity degrees(t=8.460,14.872;all P<0.001),while no significant difference was found in degreeⅡ(t=0.923,P=0.631).The intestinal dysbiosis was correlated with the type of disease and severity of symptoms(r=0.452,0.586;all P<0.001).Conclusion IBS patients suffer intestinal dysbiosis,which varies among the type of disease and severity of symptoms.Clinical treatment can be given based on the change of flora in intestinal lavage fluid.