肠道菌群与呼吸道感染患者免疫球蛋白的关系及其肠内营养的疗效  

The relationship between intestinal flora disorder and immunoglobulin level in patients with respiratory tract infection and the effect of enteral nutrition therapy

作　　者：罗先平[1] 代建华 潘丹 LUO Xianping;DAI Jianhua;PAN Dan(Department of Internal Medicine,Yuechi County Hospital of Traditional Chinese Medicine,Yuechi,Sichuan 638300,China;不详)

机构地区：[1]岳池县中医医院内一科,四川岳池638300 [2]岳池县中医医院检验科,四川岳池638300

出　　处：《中国微生态学杂志》2020年第8期920-924,共5页Chinese Journal of Microecology

摘　　要：目的分析肠道菌群紊乱对呼吸道感染患者免疫球蛋白水平的影响,探讨肠内营养对此类患者的疗效。方法选取2016年2月至2018年12月在我院接受治疗的116例呼吸道感染患者作为观察组,进一步将其分为非菌群失调组(50例)和菌群失调组(66例),选取同期60例健康体检者作为对照组,比较各组对象肠道菌群失调情况和血清免疫球蛋白水平,同时对菌群失调患者在常规治疗基础上联合应用肠内营养治疗,观察其治疗效果。结果(1)观察组患者肠道乳杆菌、双歧杆菌数量及双歧杆菌/大肠埃希菌比值(B/E)显著低于对照组,而肠球菌、大肠埃希菌数量显著高于对照组(均P<0.05);观察组患者血清IgM、IgA、IgG水平均显著低于对照组(均P<0.05);菌群失调组患者血清IgM、IgA、IgG水平均显著低于非菌群失调组(均P<0.05)。(2)观察组患者肠道乳杆菌、双歧杆菌数量及B/E值与血清IgM、IgA、IgG水平呈显著正相关(均P<0.05),而大肠埃希菌和肠球菌数量与之呈显著负相关(均P<0.05)。(3)菌群失调组患者血清ALB、PA水平随治疗时间的延长而逐渐升高,CRP、PCT水平逐渐降低,IgM、IgA、IgG水平逐渐升高,乳杆菌、双歧杆菌数量和B/E值逐渐增加,大肠埃希菌和肠球菌数量逐渐减少(均P<0.05)。结论呼吸道感染患者存在明显的肠道菌群失调情况,其与患者免疫球蛋白水平的降低有关,这可能是引发呼吸道感染的主要危险因素。肠内营养支持疗法能有效改善患者肠道菌群失调,降低血清炎性因子水平,增强机体免疫力,提高患者营养状况及治疗效果。Objective To analyze the effect of intestinal flora disorder on immunoglobulin level and explore the efficacy of enteral nutrition in patients with respiratory tract infection.Methods A total of 116 patients with respiratory tract infection were divided into non-dysbacteriosis group(50 cases)or dysbacteriosis group(66 cases).Sixty healthy people who underwent health examination in our hospital were selected as the control group.The intestinal flora and levels of serum immunoglobulin were compared among groups.Sixty-six patients with dysbacteriosis were treated with enteral nutrition on the basis of conventional treatment,and the efficacy was observed.Results(1)The counts of Lactobacillus,Bifidobacterium and Bifidobacterium/Escherichia coli(B/E)in the observation groups were significantly lower than those in the control group,and the counts of Enterococcus and Escherichia coli in the observation groups were significantly higher than those in the control group(all P<0.05).The serum IgM,IgA and IgG in the observation groups were significantly lower than those in the control group(all P<0.05).The serum IgM,IgA and IgG of the patients with dysbacteriosis were significantly lower than those of the patients without dysbacteriosis(all P<0.05).(2)The levels of serum IgM,IgA and IgG were positively correlated with the counts of Lactobacillus and Bifidobacterium and B/E in stool samples(all P<0.05),and negatively correlated with the counts of Escherichia coli and Enterococcus(all P<0.05).(3)After treatment,the serum ALB and PA in dysbacteriosis group increased gradually;CRP and PCT decreased gradually;serum IgM,IgA and IgG increased gradually;Lactobacillus,Bifidobacterium and B/E increased gradually,and the counts of E.coli and Enterococcus decreased gradually(all P<0.05).Conclusion Patients with respiratory tract infection have obvious intestinal flora imbalance and immunoglobulin reduction,which may be the risk factors for respiratory tract infections.The combined enteral nutrition support therapy can effectively enhance

关 键 词：呼吸道感染 肠道菌群紊乱 免疫球蛋白 肠内营养 治疗效果 

分 类 号：R574[医药卫生—消化系统]