反复肺部感染儿童的肠道状况研究

Intestinal condition of children with recurrent pulmonary infection

目的比较反复肺部感染儿童和健康儿童的肠道状况。方法选取2013年1月至2015年4月于我院接受治疗的300例反复肺部感染儿童作为观察组,同期入院检查的300例正常儿童作为对照组。取两组儿童1 g粪便进行肠道菌群检验,比较两组儿童双歧杆菌、肠杆菌、乳酸杆菌、拟杆菌、肠球菌以及酵母菌的数量对数值;计算并比较双歧杆菌与肠杆菌比值(B/E);检验并比较两组儿童血浆内毒素、二胺氧化酶、血浆D-乳酸、黏液蛋白以及免疫球蛋白A(SIg A)的含量;比较两组儿童肠道病毒阳性情况、肠黏膜通透性发生情况。结果观察组儿童肠道菌群数量对数值中,双歧杆菌(7.10±0.59)、肠杆菌(7.86±0.47)、乳酸杆菌(5.17±1.01)、拟杆菌(4.19±1.01)、肠球菌(6.12±0.87)、酵母菌(4.12±1.08),对照组儿童双歧杆菌(9.56±0.82)、肠杆菌(4.17±0.54)、乳酸杆菌(8.01±1.05)、拟杆菌(8.14±0.93)、肠球菌(9.41±0.71)、酵母菌(7.71±0.84),观察组B/E值为0.90,对照组B/E值为2.29,两组数据比较差异均具有统计学意义(P<0.05);观察组儿童血浆内毒素为(0.06±0.02)EU/m L、二胺氧化酶(1.84±0.45)U/m L、血浆D-乳酸(3.70±0.72)μg/m L、黏液蛋白(247.41±80.10)μg/g、SIg A含量(395.85±108.42)μg/g,对照组儿童血浆内毒素为(0.003±0.001)EU/m L、二胺氧化酶(0.83±0.21)U/m L、血浆D-乳酸(1.92±0.68)μg/m L、黏液蛋白(310.62±76.54)μg/g、SIg A含量(516.91±110.27)μg/g,两组数据比较差异均具有统计学意义(P<0.05);观察组儿童病毒阳性104例(34.7%)、肠黏膜通透性增强187例(62.3%),对照组病毒阳性7例(2.3%)、肠黏膜通透性增强4例(1.3%),两组数据比较差异均具有显著统计学意义(P<0.01)。结论反复肺部感染儿童肠道菌群更易失调,肠道免疫屏障和肠黏膜易受到损伤,肠道状况较差。

Objective To compare the intestinal condition of children with recurrent pulmonary infection and healthy children. Methods A total of 300 cases of children with pulmonary infection, who admitted to our hospital from January 2013 to April 2015, were selected as the observation group. At the same time, 300 cases of normal children were selected as the control group. Feces(1 g) of the two groups were collected to examine the intestinal microbiota.The logarithm of the number of Bifidobacterium, Enterobacter, Lactobacillus, Bacteroides, Enterococcus and Yeast in the two groups was compared. the ratio of bifidobacteria to enterobacteria(B/E) was calculated. The levels of plasma endotoxin, diamine oxidase, plasma D-lactate, mucin protein and immunoglobulin A(SIg A) in the two groups were tested and compared; the positive rate of enteroviruses and the permeability of intestinal mucosa in the two groups were compared. Results The logarithm of the number of Bifidobacterium, Enterobacter, Lactobacillus, Bacteroides, Enterococcus and Yeast in the observation group and the control group were respectively(7.10±0.59) and(9.56±0.82),(7.86±0.47)and(4.17±0.54),(5.17±1.01) and(8.01±1.05),(4.19±1.01) and(8.14±0.93),(6.12±0.87) and(9.41±0.71),(4.12±1.08)and(7.71±0.84); the ratios of B/E in the observation group and the control group were respectively 0.90 and 2.29. All of the above differences were statistically significant(P<0.05). The levels of plasma endotoxin, diamine oxidase, plasma D-lactate, mucin protein and immunoglobulin A(SIg A) in the observation group and the control group were respectively(0.06±0.02) EU/m L and(0.003±0.001) EU/m L,(1.84±0.45) U/m L and(0.83±0.21) U/m L,(3.70±0.72) μg/m L and(1.92±0.68) μg/m L,(247.41±80.10) μg/g and(310.62±76.54) μg/g,(395.85±108.42) μg/g and(516.91±110.27) μg/g, and all the above differences were statistically significant(P<0.05). The positive rate of enteroviruses and the permeability of intestinal mucosa in the observation group and the control group were respectively 104 cases(34.7%) and 7 cases(2.3%),187 cases(62.3%) and 4 cases(1.3%), and the differences were statistically significant(P<0.01). Conclusion The intestinal microbiota of children with recurrent pulmonary infection is more likely to be in disorder, which will lead to intestinal immune barrier and intestinal mucosa vulnerable to damage, and deterioration of intestinal conditions.