肠道菌群与肠易激综合征分型及患者血清细胞间黏附分子-1表达的关系

The relationship between intestinal flora and IBS subtypes and serum ICAM-1expression

目的分析肠道菌群与IBS分型及患者血清细胞间黏附分子-1(ICAM-1)表达的关系,为后续研究提供参考。方法选择2018年12月至2020年1月我院收治的152例符合标准的肠易激综合征(IBS)患者作为观察组,并依照罗马Ⅲ标准将观察组患者分为腹泻型组(62例)、便秘型组(56例)、混合型组(34例);选择同期我院健康体检者30例为对照组。检测受试者粪便中双歧杆菌、乳杆菌、肠杆菌和肠球菌数量,同时检测受试者血清ICAM-1水平。采用Pearson相关性分析患者肠道菌群与血清ICAM-1关系,并采用Logistics回归模型分析肠道菌群与IBS各亚型的关系。结果观察组患者血清ICAM-1、肠道双歧杆菌、乳杆菌水平显著低于对照组,肠道肠杆菌和肠球菌水平显著高于对照组,差异均有统计学意义(均P<0.05)。不同亚型IBS患者血清ICAM-1、肠道双歧杆菌、乳杆菌、肠杆菌和肠球菌水平存在明显差异,其中混合组患者血清ICAM-1、肠杆菌、肠球菌数量最高,双歧杆菌、乳杆菌数量最低;腹泻型组肠道肠杆菌、肠球菌数量最低,双歧杆菌、乳杆菌数量最高(均P<0.05)。肠道中双歧杆菌、乳杆菌、肠杆菌、肠球菌数量是IBS分型的独立影响因素(均P<0.05)。患者肠道双歧杆菌、乳杆菌数量与ICAM-1水平呈显著负相关,而肠道肠杆菌和肠球菌数量与ICAM-1水平呈显著正相关(均P<0.05)。结论肠道菌群可影响IBS患者分型,且肠道中部分菌群与ICAM-1水平存在显著相关关系。

Objective To analyze the relationship of intestinal flora with subtypes of irritable bowel syndrome(IBS)and the expression of serum ICAM-1,and provide a reference for the following study.Methods A total of 152patients with IBS in our hospital from December 2018to January 2020who met the criteria of inclusion were enrolled as the observation group,which was subdivided into diarrhea group(62case),constipation group(56case)and mixed type group(34case)according to the Rome III standard.30healthy individuals who received physical examination in the same period were enrolled as the control group.The counts of Bifidobacterium,Lactobacillus,Enterobacteriaceae and Enterococcus in the feces and serum level of ICAM-1were detected.Pearson correlation analysis was performed to analyze the relationship between intestinal flora and serum ICAM-1.Logistics regression model was used to analyze the relationship between intestinal flora and each IBS subtype.Results The levels of serum ICAM-1,intestinal Bifidobacteriumand Lactobacillus in observation group were significantly lower,while those of intestinal Enterobacteriaceae and Enterococcus were significantly higher than in the control group,respectively(all P<0.05).There were significant differences in the levels of ICAM,Bifidobacterium,Lactobacillus,Enterobacteriaceae and En-terococcus among different types of IBS.The number of serum ICAM-1,Enterobacter and Enterococcus in the mixed group were the highest,the number of Bifidobacteriumand Lactobacillus were the lowest.The number of Enterobacter and Enterococcus in the diarrhea group were the lowest,and the number of Bifidobacteriumand Lactobacillus was the highest(all P<0.05).Bifidobacterium,Lactobacillus,Enterobacter and Enterococcus were independent influencing factors of IBS typing(all P<0.05).The counts of intestinal Bifidobacteriumand Lactobacillus were negativelycorrelated with ICAM-1level,while counts of Enterobacter and Enterococcus were positively correlated with ICAM-1level.Conclusion Intestinal flora is an independent influencing factor for each subtype of IBS,and there is a significant correlation between intestinal microflora and ICAM-1level.