炎症性肠病与艰难梭菌感染的相关性  

Relationship Between Inflammatory Bowel Disease and Clostridium Difficile Infection

作　　者：荀津[1] 夏冰[1] 彭谋[1] 陈立平[1] 王伟[1] 易烽明[1] 

机构地区：[1]武汉大学中南医院消化内科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2012年第5期680-683,共4页Medical Journal of Wuhan University

基　　金：武汉大学2010年大学生科研项目(编号:S2010438)

摘　　要：目的:检测湖北省武汉市地区炎症性肠病(IBD)患者艰难梭菌感染率,探讨IBD与艰难梭菌感染的相关性。方法:纳入2010年9月至2011年12月在武汉大学中南医院确诊的56例IBD患者作为IBD组,包括36例溃疡性结肠炎(UC)和20例克罗恩病(CD),收集其粪便标本及临床资料,包括IBD诊断、疾病活动性、分型及病变累及部位等。纳入同时期体检的40例健康成年人作为对照组。采用EIA法检测研究对象粪便中艰难梭菌毒素A&B,分析IBD临床资料与艰难梭菌感染的相关性。结果:IBD组中共检出6例阳性(10.71%),对照组未检出阳性。UC患者艰难梭菌感染率低于CD患者(P<0.05),处于疾病活动期的IBD患者艰难梭菌感染率显著高于缓解期患者(P<0.01),初发型IBD患者艰难梭菌感染率高于非初发型患者(P<0.01),结肠受累者艰难梭菌感染率显著高于非结肠受累者(P<0.01)。结论:与健康成年人相比,IBD患者艰难梭菌感染率明显升高,活动期及结肠受累的IBD患者可能更易感染艰难梭菌。Objective： To detect the rate of Clostridium difficile infection in patients of inflammatory bowel disease（IBD） and to investigate the relationship between IBD and Clostridium difficile infection.Methods： Fifty-six IBD patients who were diagnosed in Zhongnan Hospital of Wuhan University from September 2010 to December 2011 were admitted as IBD group,including 36 ulcerative colitis（UC） patients and 20 Crohn＇s disease（CD） patients.We collected their stool species and clinical characteristics such as diagnosis,disease activity,classification,anatomic location and so on.Forty healthy adults were admitted as control group.We detected Clostridium difficile toxins AB with EIA and analyzed the relationship between IBD clinical characteristics and Clostridium difficile infection.Results： There were 6 positive cases in IBD group（10.71%） and none positive in control group.UC patients had a lower rate of Clostridium difficile infection than CD group（P〈0.05）.The rate was higher in patients of active IBD,first-occurred IBD,and IBD patients who had colonic involvement（all P〈0.01）.Conclusion： The rate of Clostridium difficile infection in IBD patients is higher than that in healthy adults.IBD patients with active disease or colonic involvement may be more likely to have Clostridium difficile infection.

关 键 词：炎症性肠病 艰难梭菌 溃疡性结肠炎 克罗恩病 

分 类 号：R574.6[医药卫生—消化系统]