新生儿过敏性结肠炎肠道菌群变化及其与肠梗阻的关系分析

Changes of Intestinal Flora in Neonates with Allergic Colitis and Analysis of Its Relationship with Intestinal Obstruction

目的探讨新生儿过敏性结肠炎(AC)肠道菌群变化情况及其与肠梗阻的关系。方法选取2018年1月至2022年8月本院收治的228例确诊为AC的新生儿作为研究组,另以胎龄、出生体质量、日龄1:1匹配同时期在本院体检的228例健康新生儿作为对照组。采集研究组患儿确诊AC当天(对照组体检当天)自然排泄粪便样本,采用16S rDNA荧光定量多聚酶链式反应(PCR)技术对2组粪便样本中的主要肠道菌群(双歧杆菌、乳酸杆菌、大肠杆菌、肠球菌、拟杆菌属、酵母菌)进行分析比较。统计研究组AC新生儿治疗期间并发肠梗阻的情况,比较肠梗阻患儿与无肠梗阻患儿主要肠道菌群的分布情况,并采用Logistic回归分析AC患儿肠道菌群变化与肠梗阻之间的关系。结果研究组新生儿肠道中双歧杆菌、乳酸杆菌、拟杆菌含量低于对照组(P<0.05);大肠杆菌、肠球菌含量高于对照组(P<0.05);酵母菌含量与对照组对比无统计学差异(P>0.05);228例AC患儿在治疗期间肠梗阻的发生率为17.98%(41/228);Logistic回归分析显示,AC患儿肠道中大肠杆菌、肠球菌的含量高为其发生肠梗阻的独立危险因素(P<0.05),双歧杆菌、乳酸杆菌、拟杆菌的含量高为保护因素(P<0.05)。结论AC新生儿的肠道中的双歧杆菌、乳酸杆菌、拟杆菌含量降低,大肠杆菌、肠球菌含量升高,且以上肠道菌群变化均是AC患儿发生肠梗阻的影响因素。

Objective To explore the changes of intestinal flora in neonates with allergic colitis(AC)and its relationship with intestinal obstruction.Methods 228 neonates diagnosed as AC in our hospital from January 2018 to August 2022 were selected as the study group,and 228 healthy neonates matched with the ratio of 1:1 by gestational age,birth weight and day age who had physical examination in our hospital at the same time were selected as the control group.The natural fecal samples of the children were collected on the day of diagnosis of AC in the study group(on the day of physical examination in the control group),and 16S rDNA fluorescence quantitative polymerase chain reaction(PCR)was used to analyze and compare the main intestinal flora(Bifidobacteria,Lactobacillus,Escherichia coli,Enterococcus,Bacteroides,Yeast)in two groups of fecal samples.The concurrency of intestinal obstruction in the AC neonates of the study group during treatment was counted,and the distribution of the main intestinal flora were compared between the children with or without intestinal obstruction.Logistic regression was used to analyze the relationship between the changes of intestinal flora and intestinal obstruction in the children with AC.Results The content of Bifidobacterium,Lactobacillus and Bacteroides in intestinal tract of neonates in the study group was lower than that in the control group(P<0.05),while the content of Escherichia coli and Enterococcus in the study group was higher than that in the control group(P<0.05),but there was no significant difference in content of Yeast between the control group and the control group(P>0.05).The incidence rate of intestinal obstruction in 228 children with AC during treatment was 17.98%(41/228).Logistic regression analysis showed that high levels of Escherichia coli and Enterococcus were independent risk factors for intestinal obstruction in children with AC(P<0.05),but high levels of Bifidobacterium,Lactobacillus and Bacteroides were protective factors(P<0.05).Conclusion In intestinal tract of neonates with AC,the content of Bifidobacterium,Lactobacillus and Bacteroides decrease while the content of Escherichia coli and Enterococcus increase.The changes of above intestinal flora are the influencing factors of intestinal obstruction in neonates with AC.