不同病程老年帕金森病患者肠道菌群和血清氨基酸水平的变化  

Changes of intestinal flora and serum amino acid levels in elderly patients with Parkinson's disease at different stages

作　　者：彭越[1] 贺迎坤 王丽丽[1] 王冰[1] Peng Yue;He Yingkun;Wang Lili;Wang Bing(Department of Neurology,Henan Provincial People's Hospital,Zhengzhou 450003,China;Department of Intervention,Henan People's Cerebrovascular Disease Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省人民医院神经内科,郑州450003 [2]河南省人民脑血管病医院介入科,郑州450000

出　　处：《中华老年医学杂志》2021年第2期153-157,共5页Chinese Journal of Geriatrics

基　　金：国家自然科学基金项目(81601583)。

摘　　要：目的探讨不同病程老年帕金森病(PD)患者肠道菌群和血清氨基酸水平的变化,为临床诊断、预防和治疗PD提供依据。方法选取2018年1月至2019年8月在我院诊治的老年PD患者140例,根据病程划分为<5年PD组(70例)和≥5年PD组(70例),并选取我院体检非PD老年人(90例)作为对照组。采用16S rDNA基因实时荧光定量PCR法检测三组人群肠道中双歧杆菌、乳酸杆菌、普拉梭菌、肠球菌、肠杆菌、Prevotella copri菌和Akkermansia muciniphila菌水平,应用高效液相色谱法检测三组人群血清氨基酸。结果与对照组相比,<5年PD组和≥5年PD组患者肠道中双歧杆菌、乳酸杆菌、普拉梭菌和Prevotella copri菌水平降低,肠杆菌水平升高(F值分别为20.863、32.251、23.166、24.683、10.136,均P<0.001)。与对照组相比,<5年PD组和≥5年PD组患者血清甲硫氨酸、色氨酸、赖氨酸、谷氨酸水平降低(F值分别为5.858、5.877、4.183、25.462,均P<0.05)。Spearman相关性分析显示,血清谷氨酸与肠道中普拉梭菌呈正相关(r=0.647,P=0.002),与Prevotella copri菌呈负相关(r=-0.559,P=0.010)。多因素Logistic回归方程分析显示,老年PD患者肠道中的保护因素为双歧杆菌(OR=0.186,95%CI=0.054~0.637,P=0.007)、乳酸杆菌(OR=0.283,95%CI=0.098~0.816,P=0.020)、普拉梭菌(OR=0.232,95%CI=0.063~0.851,P=0.028)、Prevotella copri菌(OR=0.222,95%CI=0.058~0.851,P=0.028),危险因素为肠杆菌(OR=5.119,95%CI=1.406~18.636,P=0.013)。结论老年PD患者肠道中双歧杆菌、乳酸杆菌、普拉梭菌、Prevotella copri菌水平降低和肠杆菌水平升高,以及血清谷氨酸水平的降低,可能与老年PD病程发展有关。Objective To investigate the changes of intestinal flora and serum amino acid levels in elderly patients with Parkinson's disease(PD)at different stages,and to provide evidence for diagnosis,prevention and treatment of PD.Methods A total of 140 elderly PD patients diagnosed and treated in our hospital from January 2018 to August 2019 were enrolled and divided into PD course<5 years group(n=70)and PD course≥5 years group(n=70).Ninety subjects without PD confirmed by medical examination in our hospital were included as the control group.Real-time fluorescence quantitative PCR of 16S rDNA gene was used to detect levels of Bifidobacterium,Lactobacillus,Clostridium prasus,Enterococcus,Enterobacter,Prevotella copri and Akkermansia muciniphila bacteria in the gut,and the high-performance liquid chromatography was used to detect the serum amino acids in the three groups.Results Compared with the control group,the levels of Bifidobacterium,Lactobacillus,Clostridium prasalis and Prevotella copri in the intestines were decreased and Enterobacter level was increased in PD course<5 years group and PD course≥5 year group(F=20.863,32.251,23.166,24.683 and 10.136,all P<0.001).The serum levels of methionine,tryptophan,lysine and glutamate in PD course<5 years and PD course≥5 year group were decreased as compared with the control group(F=5.858,5.877,4.183 and 25.462,all P<0.05).Spearman correlation analysis showed that serum glutamate level was positively correlated with Clostridium prastia in the intestine(r=0.647,P=0.002)and negatively correlated with Prevotella copri(r=-0.559,P=0.010).Multivariate Logistic regression analysis showed that the protective factors in the intestines of elderly PD patients were Bifidobacterium(OR=0.186,95%CI:0.054-0.637,P=0.007),Lactobacillus(OR=0.283,95%CI:0.098-0.816,P=0.020),Clostridium prastia(OR=0.232,95%CI:0.063-0.851,P=0.028),and Prevotella copri(OR=0.222,95%CI:0.058-0.851,P=0.028),and the risk factor was Enterobacter(OR=5.119,95%CI:1.406-18.636,P=0.013).Conclusions The decreases of Bifi

关 键 词：帕金森病 肠道菌群 氨基酸类 

分 类 号：R742.5[医药卫生—神经病学与精神病学]