溃疡性结肠炎患者不同发病状态肠道菌群、炎症因子变化及优势菌敏感性抗菌药物分析  

Changes of intestinal flora,inflammatory factors and sensitivity of dominant bacteria to antibiotics in different disease status

作　　者：徐宝琪 张燕红 李伊倩 Xu Baoqi;Zhang Yanhong;Li Yiqian(Department of Gastroenterology,Third People’s Hospital of Dongguan,Dongguan 523320,China)

机构地区：[1]东莞市第三人民医院消化内科,东莞市523320

出　　处：《中华实验和临床感染病杂志（电子版）》2020年第1期51-56,共6页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：东莞市社会科技发展(一般)项目(No.2018507150241544)。

摘　　要：目的探讨溃疡性结肠炎患者不同发病状态肠道菌群改变、炎症因子水平变化及优势菌敏感性抗菌药物。方法选取2018年1月至2019年2月于东莞市第三人民医院收治的77例溃疡性结肠炎患者作为研究对象,根据入组时临床表现将其分为急性组(15例)、慢性复发组(35例)和慢性持续组(27例);同期选取30例健康体检人群作为对照组。分析各组研究对象粪便菌群结构,并用平板计数其菌落数量,同时进行药敏试验;检测各组血清白细胞介素-6(IL-6)、白细胞介素-10(IL-10)和肿瘤坏死因子-α(TNF-α)水平,并分析其与优势菌群数量及优势菌药物敏感率间的关系。结果急性组、慢性复发组、慢性持续组和对照组研究对象大肠埃希菌株数、双歧杆菌株数和大肠埃希菌/双歧杆菌比值差异均有统计学意义(F=58.648、31.624、61.372,P均<0.001)。大肠埃希菌计数和大肠埃希菌/双歧杆菌比值比较:急性组高于慢性复发组(t=2.205、P=0.032;t=6.422、P<0.001),慢性复发组高于慢性持续组(t=3.515、P=0.001;t=7.477、P<0.001),慢性持续组高于对照组(t=4.450、P<0.001;t=15.257、P<0.001);双歧杆菌计数比较:急性组低于慢性复发组(t=6.197、P<0.001),慢性复发组低于慢性持续组(t=14.033、P<0.001),慢性持续组低于对照组(t=8.062、P<0.001)。急性组、慢性复发组和慢性持续组可能细菌感染(优势菌)率依次降低,分别为66.67%(10/15)、8.57%(3/35)和14.80%(4/27),差异有统计学意义(χ2=21.87、P<0.001)。优势菌中占比较大(大肠埃希菌和金黄色葡萄球菌)者药敏试验结果显示,大肠埃希菌和金黄色葡萄球菌首选敏感抗菌药物分别为哌拉西林/舒巴坦和万古霉素,其敏感率均为100%(9/9和5/5),其次分别为头孢曲松和环丙沙星,敏感率分别为77.78%(7/9)和80.00%(4/5)。急性组、慢性复发组、慢性持续组和对照组血清IL-6、IL-10和TNF-α水平差异均有统计学意义(F=246.780、196.452、164.62Objective To investigate the changes of intestinal flora,inflammatory factor levels and antimicrobial susceptibility in different disease status of ulcerative colitis.Methods Total of 77 cases with ulcerative colitis treated in the Third People’s Hospital of Dongguan,from January 2018 to February 2019 were selected,which were divided into acute group(15 cases),chronic recurrence group(35 cases)and chronic persistent group(27 cases)according to the clinical manifestations,while 30 healthy patients were selected as control group.The faecal flora structure of each group were analyzed,and the colony number was counted by plate,meanwhile,drug sensitivity test were done.The levels of serum interleukin-6(IL-6),interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)were also detected,the relationship between the number of dominant bacteria and drug sensitivity of dominant bacteria were analyzed,respectively.Results There were significant differences in the number of Escherichia coli,Bifidobacterium and the ratio of Escherichia coli/Bifidobacterium in acute group,chronic recurrent group,chronic persistent group and control group(F=58.648,31.624,61.372,all P<0.001).Comparison of Escherichia coli counts and Escherichia coli/Bifidobacterium ratios:the acute group was higher than chronic recurrent group(t=2.205,P=0.032;t=6.422,P<0.001),the chronic recurrent group was higher than the chronic persistent group(t=3.515,P=0.001;t=7.477,P<0.001),and chronic persistent group was higher than control group(t=4.450,P<0.001;t=15.257,P<0.001),all with significant differences.Comparison of Bifidobacterium count:the acute group was lower than chronic recurrent group(t=6.197,P<0.001),chronic recurrent group was lower than chronic persistent group(t=14.033,P<0.001),and the chronic persistent group was lower than the control group(t=8.062,P<0.001),all with significant differences.The rate of possible bacterial infection(dominant bacteria)decreased sequentially in the acute group,chronic recurrent group and chronic persistent group,which w

关 键 词：溃疡性结肠炎 肠道菌群 敏感性 相关性 

分 类 号：R574.62[医药卫生—消化系统]