溃疡性结肠炎患者肠道菌群丰度与血内毒素、免疫球蛋白、IL-23及疾病活动度的关系

The relationship between intestinal flora abundance and blood endotoxin,immunoglobulin,IL-23 and disease activity in patients with ulcerative colitis

目的探讨溃疡性结肠炎(ulcerative colitis,UC)患者肠道菌群丰度与血内毒素、免疫球蛋白、IL-23及疾病活动度的关系。方法选择2021年1月至2022年3月在我院诊治的UC患者106例,处于活动期63例作为活动期组,根据改良梅奥评分(Mayo)划亚组:轻度组(3~5分)21例,中度组(6~10分)27例,重度组(11~12分)15例;处于缓解期43例作为缓解期组,另选同期来我院健康体检的50名志愿者作为对照组。对各组肠道菌群丰度、血内毒素、免疫球蛋白、IL-23水平进行检测与比较,采用Pearson相关性分析UC患者肠道菌群丰度与血内毒素、免疫球蛋白、IL-23及疾病活动度的关系。结果各组肠道菌群丰度、血内毒素、免疫球蛋白、IL-23水平比较,差异均有统计学意义(P<0.05),且活动期组肠道菌群丰度、IgM水平低于缓解期组(P<0.05),缓解期组低于对照组(P<0.05);活动期各组血内毒素、IgG、IgA、IL-23水平高于缓解期组(P<0.05),缓解期组高于对照组(P<0.05);Pearson相关性分析结果显示,肠道菌群丰度与疾病活动度、IgA、IL-23水平有相关性(P<0.05)。结论活动期UC患者存在肠道菌群失调,其肠道菌群丰度下降,改变的细菌与免疫球蛋白、IL-23、疾病活动度密切相关,上述相关指标的相互作用在UC的发生发展过程中起十分关键的作用。

Objective To investigate the relationship between intestinal flora abundance and blood endotoxin,immunoglobulin,IL-23 and disease activity in patients with ulcerative colitis(UC).Methods A total of 106 patients with UC diagnosed and treated in our hospital from Jan.2021 to Mar.2022 were selected.Sixty-three patients were in the active phase as the active phase group.According to the modified Mayo score,there were 21 patients in the mild group(3-5 points),27 patients in the moderate group(6-10 points),and 15 patients in the severe group(11-12 points).Fourty-three patients in remission stage were taken as the remission group,and 50 volunteers in the same period of physical examination in our hospital were taken as the control group.The intestinal flora abundance,blood endotoxin,immunoglobulin and IL-23 levels in each group were detected and compared.The relationship between intestinal flora abundance and blood endotoxin,immunoglobulin,IL-23 and disease activity were analyzed by Pearson correlation.Results There were significant differences in intestinal flora abundance,blood endotoxin,immunoglobulin and IL-23 levels among the groups(P<0.05).The intestinal flora abundance and IgM level in the active phase group were lower than those in the remission phase group(P<0.05),and the above indicators in the remission phase group were lower than those in the control group(P<0.05).The levels of blood endotoxin,IgG,IgA and IL-23 in each group were higher than those in the remission phase group(P<0.05),and the remission phase group were higher than those in the control group(P<0.05);Pearson correlation analysis showed that the intestinal flora abundance was correlated with disease activity,IgA and IL-23 levels(P<0.05).Conclusion Patients with active UC have obvious imbalance of intestinal flora,and their intestinal flora abundance decreases.The changed bacteria are closely related to the patients'immunoglobulin,IL-23 and disease activity.The interaction of the above related indicators plays a key role in the occurrence and development of UC.