慢性阻塞性肺疾病合并糖尿病患者口腔菌群及肠道菌群的研究

The oral and intestinal flora in COPD patients with diabetes mellitus

目的探讨慢性阻塞性肺疾病(COPD)合并糖尿病患者与糖尿病患者口腔菌群及肠道菌群的差异。方法选取2019年5月到2020年5月于我院就诊的COPD合并糖尿病患者与仅患糖尿病的患者各30例。检测两组患者的各项身体指标以及生化指标。采集两组患者牙体颊/舌面液体,提取细菌基因组DNA,采用荧光定量PCR鉴定常见口腔细菌。采用贴纸收集粪便样本,并用选择性琼脂培养基培养菌群,结果以每毫升粪便的菌落形成单位(CFU)表示。通过BBL Crystal;鉴定系统对分离出的细菌进行鉴定。采用Elisa试剂盒测量粪便中Zonulin的水平(ng/mL)。结果COPD合并糖尿病患者体质量指数[(29.54±2.16)kg/m;]较高,血糖水平也较高,但与糖尿病组比较差异无统计学意义(均P>0.05)。COPD合并糖尿病患者CRP水平升高(P<0.05),其他各项指标两组间差异无统计学意义(均P>0.05)。30例COPD合并糖尿病患者链球菌检出率为60.0%,奈瑟菌检出率为30.0%,放线菌检出率为66.7%,韦荣球菌检出率为40.0%,牙龈卟啉单胞菌的检出率为70.0%。30例糖尿病患者链球菌检出率为40.0%,奈瑟菌检出率为56.7%,放线菌检出率为36.7%,韦荣球菌检出率为73.3%,牙龈卟啉单胞菌的检出率为46.7%。Zonulin与炎症和真菌数量之间存在显著正相关。结论COPD合并糖尿病患者肠道真菌数量、肠屏障功能与全身性炎症之间存在密切联系。

Objective To explore the difference in oral flora and intestinal flora between COPD patients with diabetes and diabetic patients.Methods A total of 30 COPD patients with diabetes and 30 patients with only diabetes who were treated in our hospital from May 2019 to May 2020 were selected.Various physical indexes and biochemical indexes in both groups were detected.Buccal/lingual fluid of teeth from the two groups of patients were collected and the bacterial genomic DNA were extracted.The oral flora was detected with fluorescent quantitative PCR.Stool samples were collected through stickers and inserted into sealed vials with specific media.The results were expressed in colony forming units(CFU)per milliliter of feces.Bacteria tests were performed on the isolated organisms through the BBL Crystal;identification system.Zonulin in feces was detected using Elisa kit(ng/mL).Results The patients with COPD and diabetes had a higher body mass index[(29.54±2.16)kg/m~2]and a correspondingly higher blood sugar content.There were no significant differences between groups(all P>0.05).The expression of CRP content in COPD patients with diabetes was up-regulated(P<0.05).There were no significant differences in other indicators between the two groups(all P>0.05).The detection rate of Streptococcus in the 30 COPD patients with diabetes was 60.0%,that of Neisseria was 30.0%,that of Actinomycetes was 66.7%,that of Veillonella was 40.0%and that of Porphyromonas gingivalis was 70.0%.The detection rate of Streptococcus in the 30 diabetic patients was 40.0%,that of Neisseria was 56.7%,that of Actinomyces was 36.7%,that of Veillonella was 73.3%,and that of Porphyromonas gingivalis was 46.7%.Zonulin had a positive correlation with inflammation and the count of fungi.Conclusion In COPD patients with diabetes,there is a close relationship among the count of intestinal fungi,intestinal barrier function and subsequent systemic inflammation.