溃疡性结肠炎患者肠道乳酸杆菌变化及其与临床分期、炎症指标的关系

Changes of intestinal lactobacillus and their relationship with clinical staging and inflammatory indexes in pa⁃tients with ulcerative colitis

目的探讨溃疡性结肠炎(UC)患者肠道乳酸杆菌变化及其与临床分期、炎症指标的关系。方法选取120例UC患者为UC组,其中活动期69例、缓解期51例;另按照年龄、性别适配原则选取同期在本院体检的60例健康志愿者为对照组,比较两组的肠道乳酸杆菌、炎症指标水平,并分析UC组患者各指标其与病情分期的关系,以及乳酸杆菌与炎症指标的关系。结果UC组患者乳酸杆菌数量、血清白介素-4(IL-4)水平低于对照组,差异均有统计学意义(t分别=8.17、25.42,P均<0.05),血清白介素-17(IL-17)、白介素-23(IL-23)、肿瘤坏死因子-α(TNF-α)水平明显高于对照组,差异均有统计学意义(t分别=-16.70、-16.02、-15.67,P均<0.05)。UC活动期患者Mayo评分高于UC缓解期,乳酸杆菌数量明显低于UC缓解期,差异均有统计学意义(Z=-9.54,t=6.22,P均<0.05)。UC活动期患者血清IL-4水平明显低于UC缓解期,血清IL-17、IL-23、TNF-α水平明显高于UC缓解期,差异均有统计学意义(t分别=10.08、-9.12、-9.62、-8.94,P均<0.05)。UC患者肠道乳酸杆菌数量与血清IL-4水平呈正相关(r=0.56,P<0.05),与血清IL-17、IL-23、TNF-α水平呈负相关(r分别=-0.70、-0.77、-0.69,P均<0.05)。结论UC患者肠道乳酸杆菌数量明显减少,UC活动期肠道乳酸杆菌数量低于缓解期,且可能与炎症指标的变化相关。

Objective To explore the changes of intestinal lactobacillus and their relationship with clinical staging and inflammatory indexes in patients with ulcerative colitis(UC).Methods A total of 120 patients with UC were enrolled as UC group,including 69 cases in active stage and 51 cases in remission stage.According to the matching principle of age and gender,60 healthy volunteers undergoing physical examination during the same period were enrolled as control group.The levels of intestinal lactobacillus and inflammatory indexes were compared between the two groups.The relationship between different indexes and disease staging,as well as the relationship between lactobacillus and inflammatory indexes were analyzed.Results The number of lactobacillus and level of serum IL-4 in UC group were lower than those in control group(t=8.17,25.42,P<0.05),while levels of serum IL-17,IL-23 and TNF-αwere significantly higher than those in control group(t=-16.70,-16.02,-15.67,P<0.05).Mayo score in active stage was higher than that in remission stage,while number of lactobacillus was significantly lower than that in remission stage(Z=-9.54,t=6.22,P<0.05).The level of serum IL-4 in active stage was significantly lower than that in remission stage,while levels of serum IL-17,IL-23 and TNF-αwere significantly higher than those in remission period(t=10.08,-9.12,-9.62,-8.94,P<0.05).The number of intestinal lactobacillus was positively correlated with level of serum IL-4(r=0.56,P<0.05),while negatively correlated with levels of serum IL-17,IL-23 and TNF-α(r=-0.70,-0.77,-0.69,P<0.05).Conclusion The number of intestinal lactobacillus is significantly reduced in patients with UC.The number of intestinal lactobacillus in active stage is less than that in remission stage,which may be related to changes of inflammatory indexes.