溃疡性结肠炎患者肠黏膜相关菌群与临床表现的关系  

Relationship between intestinal mucosa associated microbiota and clinical manifestations in the patients with ulcerative colitis

作　　者：王深皓[1] 钟文婷 鲁晓岚[1] 史海涛[1] 赵刚[1] 张静[1] 靳耀锋[2] Wang Shenhao;Zhong Wenting;Lu Xiaolan;Shi Haitao;Zhao Gang;Zhang Jing;Jin Yaofeng(Department of Gastroenterology,The Second Affiliated Hospital of Xi＇an J iaotong University,Xi＇an 710004;The Ward 5 of Jianyuan,International Medical Center,The First Affiliated Hospital of Xi＇an Jiaotong University,Xi＇an 710061,China)

机构地区：[1]西安交通大学第二附属医院消化科,710004 [2]西安交通大学第二附属医院病理科,710004 [3]西安交通大学第一附属医院健苑五病区·涉外病房

出　　处：《中华消化杂志》2018年第11期774-779,共6页Chinese Journal of Digestion

基　　金：陕西省社会发展科技攻关项目（2016SF-175、2016SF-009）

摘　　要：目的通过研究UC患者肠黏膜相关菌群的改变情况，了解其与临床表现之间的关系。方法纳入2016年6月至10月于西安交通大学第二附属医院消化内镜中心进行结肠镜检查的28例UC患者和16名健康体检者，收集其肠道黏膜标本，进行荧光原位杂交，对肠黏膜相关细菌进行观察计数并分析其与临床表现之间的关系。统计学方法采用Kruskal—Wallis检验和Spearman秩相关分析。结果28例UC患者中，活动期16例，缓解期12例。UC活动期组和缓解期组的总菌群、大肠埃希菌、梭菌属、拟杆菌属数量均多于健康对照组，乳酸菌属和双歧杆菌属数量则均少于健康对照组，差异均有统计学意义（χ^2=23．34、19．94，23．40、12．96，23．39、19．16，23．32、10．46，23．19、4．25，18．94、12．33；P均〈0．05）；UC活动期组的总菌群、大肠埃希菌、拟杆菌属数量均多于UC缓解期组，乳酸菌属和双歧杆菌属数量则均少于UC缓解期组，差异均有统计学意义（χ^2=7．32、5．63、5．62、20．38、4．82，P均〈0．05）。UC患者的排便次数与拟杆菌数量呈正相关（r=0．459，P=0．014），与乳酸菌属数量呈负相关（r=-0．634，P〈0．01）；UC患者便血、内镜下表现和总分与总菌群、大肠埃希菌、拟杆菌属数量均呈正相关（r=0．469、0．403、0．376，0．604、0．562、0．475，0．551、0．463、0．461，P均〈0．05），与乳酸菌属和双歧杆菌属数量均呈负相关（r=-0．570、-0．413，-0．899、-0．458，-0．862、-0．480，P均〈0．05）；UC患者医师评价与大肠埃希菌数量呈正相关（r=0．415，P=0．028），与乳酸菌属和双歧杆菌属数量均呈负相关（r=-0．841、-0．529，P均〈0．01）。结论UC患者的肠道菌群发生了显著变化，并且这种变化与UC患者某些临床表现之间相关。Objective To investigate the changes of the intestinal mucosa-associated microbiota in the patients with ulcerative colitis （UC）, and to explore their correlation with the clinical manifestations. Methods From June to October 2016, at Gastrointestinal Endoscopy Center, the Second Affiliated Hospital of Xi^an Jiaotong University, 28 patients with UC and 16 healthy individuals who underwent colonoscopy examination were enrolled. The rnucosa specimens of them were collected for fluorescent in situ hybridization （FISH）. The bacterial flora were observed and counted, the correlation between the bacterial flora and the clinical manifestations were analyzed. Kruskal-Wallis test and Spearman rank correlation analysis were performed for statistical analysis. Results Among 28 patients with UC, 16 were at active phase and 12 at remission phase. The number of total bacteria flora, Escherichia coli, Clostridium and Bacteroides of the active UC group and remission UC group were all more than those of healthy control group; however the number of Lactobacillus and Bifidobacteria were less than those of healthy control group, and the differences were statistically significant （χ^2= 23. 34, 19. 94; 23. 40, 12.96; 23.39, 19,16;23.32, 10.46; 23.19, 4.25;18.94, 12.33; all P〈0.05）. The number of total bacteria flora, Escherichia coli and Bacteroides of the active UC group were more than those of the remission UC group, however the number of Lactobacillus and Bifidobacteria were less than those of the remission UC group, and the differences were statistically significant （χ^2= 7.32, 5.63, 5.62, 20.38 and 4.82; all P〈0.05）. In the patients with UC, the defecation frequency was positively correlated with the count of Bacteroides （r=0. 459, P=0. 014） and was negatively correlated with the count of Lactobacillus （r=- 0. 634, P〈0.01）. In UC patients, bloody stool, endoscopic appearance and total Mayo score were positively correlated with the counts of universal bacteria, Escherichia coli and Bacteroides （r=

关 键 词：结肠炎 溃疡性 原位杂交 荧光 肠黏膜相关菌群 临床表现 

分 类 号：R574.62[医药卫生—消化系统]