重症肺炎患者连蛋白和可溶性晚期糖基化终末产物受体与肠道菌群的相关性

Correlation between Zonulin,sRAGE and intestinal flora in patients with severe pneumonia

目的探究重症肺炎患者连蛋白(Zonulin)、可溶性晚期糖基化终末产物受体(sRAGE)表达与肠道菌群的相关性。方法选取泰州市姜堰中医院2019年1月至2022年6月收治并确诊的80例重症肺炎患者为研究组,另选取同期泰州市姜堰中医院收诊的82例普通肺炎患者为对照组。收集患者一般资料;采用酶联免疫吸附试验(ELISA)检测血清Zonulin、sRAGE水平;采用实时荧光定量聚合酶链反应(qRT-PCR)检测患者肠道菌群DNA;采用Pearson法分析Zonulin、sRAGE水平与重症肺炎患者肠道菌群的相关性。根据患者出院后28d内生存情况分为预后不良组(26例)和预后良好组(54例)。结果研究组血清中Zonulin、sRAGE水平均明显高于对照组(t=14.293、12.033,P<0.05);研究组双歧杆菌、乳酸杆菌、瘤胃球菌数量均较对照组降低(t=9.139、7.838、5.130,P<0.05),研究组肠球菌、大肠埃希菌、葡萄球菌数量均高于对照组(t=3.397、4.807、3.960,P<0.05);血清Zonulin、sRAGE水平分别与双歧杆菌、乳酸杆菌、瘤胃球菌数量呈负相关(P<0.05),与肠球菌、葡萄球菌、大肠埃希菌数量呈正相关(P<0.05);预后不良组血清Zonulin、sRAGE水平均明显高于预后良好组(t=6.910、4.358,P<0.05);双歧杆菌、乳酸杆菌和瘤胃球菌在预后不良组的数量低于预后良好组(t=4.368、2.167、3.197,P<0.05),肠球菌、葡萄球菌和大肠埃希菌在预后不良组中的数量高于预后良好组(t=2.704、3.489、3.995,P<0.05)。结论Zonulin、sRAGE在重症肺炎患者血清中水平升高,且二者水平与重症肺炎患者肠道菌群存在一定相关性。

Objective To investigate the expression levels of serum Zonulin and soluble advanced glycation end product receptor(sRAGE)in patients with severe pneumonia and their correlation with intestinal flora.Method 80 patients with severe pneumonia admitted and diagnosed in Taizhou Jiangyan Hospital of Traditional Chinese Medicine from January 2019 to June 2022 were selected as the study group,in addition,82 patients with common pneumonia were selected as the control group.General data of patients were collected;the serum levels of Zonulin and sRAGE were detected by ELISA;real-time fluorescence quantitative polymerase chain reaction(qRTPCR)was used to detect the number of intestinal flora;Pearson method was used to analyze the correlation between the levels of Zonulin,sRAGE and intestinal flora in patients with severe pneumonia.Divide patients into poor prognosis group(26 cases)and good prognosis group(54 cases)based on their survival within 28 days after discharge.Result The levels of Zonulin and sRAGE in the study group were obviously higher than those in the control group(t=14.293、12.033,P<0.05);The numbers of bifidobacterium,lactobacillus and rumen coccus in the study group were lower than those in the control group(t=9.139,7.838,5.130,P<0.05),and the numbers of enterococcus,Escherichia coli and staphylococcus in the study group were higher than those in the control group(t=3.397,4.807,3.960,P<0.05).;the levels of serum Zonulin and sRAGE were negatively correlated with the numbers of bifidobacteria,lactobacilli and rumen cocci(P<0.05),and positively correlated with the numbers of enterococci,staphylococci and Escherichia coli(P<0.05);Serum Zonulin and sRAGE levels in the poor prognosis group were significantly higher than those in the good prognosis group(t=6.910,4.358,P<0.05).The number of bifidobacterium,lactobacillus and rumen cocci in the poor prognosis group was lower than that in the good prognosis group(t=4.368,2.167,3.197,P<0.05),and the number of enterococcus,staphylococcus and Escherichia coli in the poor prognosis group was higher than that in the good prognosis group(t=2.704,3.489,3.995,P<0.05).Conclusion The levels of serum Zonulin and sRAGE in patients with severe pneumonia are elevated,and there is a certain correlation between their levels and intestinal flora in patients with severe pneumonia.