肠道菌群和肠易激综合征分型与神经内分泌轴功能变化的关系研究  

Relationship of the intestinal flora and irritable bowel syndrome sub-typing with the functional changes in the neuroendocrine axis

作　　者：游先辉[1] 王利霞 冯大超 YOU Xian-hui;WANG Li-xia;FENG Da-chao(Department of Laboratory,Chengdu Qingbaijiang District People's Hospital,Chengdu Sichuan 610300,China)

机构地区：[1]成都市青白江区人民医院检验科,四川成都610300

出　　处：《临床和实验医学杂志》2022年第15期1667-1670,共4页Journal of Clinical and Experimental Medicine

基　　金：四川省科技计划重点研发项目(编号:2020YFS0168)。

摘　　要：目的 研究肠道菌群和肠易激综合征分型与神经内分泌轴功能变化的关系。方法 采用回顾性研究,选择2019年1月至2022年2月成都市青白江区人民医院收治的100例肠易激综合征患者作研究组,按罗马Ⅲ标准分为腹泻型、便秘型与混合型;另选同期于医院体检的50名健康人群作对照组。检测各组肠道菌群、下丘脑-垂体-肾上腺轴/甲状腺轴功能指标;分析肠道菌群与分型、神经内分泌轴功能关系。结果 研究组肠道双歧杆菌、乳杆菌数量低于对照组,肠杆菌、肠球菌数量高于对照组,差异均有统计学意义(P<0.05)。不同分型患者肠道内菌群数量存在显著差异,其中腹泻型患者双歧杆菌、乳杆菌数量高于便秘型、混合型,肠杆菌、肠球菌数量低于便秘型、混合型,差异均有统计学意义(P<0.05)。肠道双歧杆菌、乳杆菌、肠杆菌、球杆菌为影响肠易激综合征分型的独立因素(P<0.05)。研究组8∶00血清促肾上腺皮质激素(ACTH)水平低于对照组,24∶00的ACTH水平高于对照组,研究组16∶00的皮质醇水平高于对照组,差异均有统计学意义(P<0.05)。两组总甲状腺素(T4)、促甲状腺素(TSH)水平比较,差异无统计学意义(P> 0.05),研究组总三碘甲状腺原氨酸(T3)、游离三碘甲状腺原氨酸(FT3)水平高于对照组,游离甲状腺素(FT4)水平低于对照组,差异均有统计学意义(P<0.05)。双歧杆菌、乳杆菌数量与ACTH 8∶00、FT4呈正相关(P<0.05),与ACTH 24∶00、皮质醇16∶00、T3、FT3呈负相关(P<0.05);肠杆菌、肠球菌数量与ACTH 8∶00、FT4呈负相关(P<0.05),与ACTH 24∶00、皮质醇16∶00、T3、FT3呈正相关(P<0.05)。结论 肠道菌群影响肠易激综合征患者分型,且肠道中菌群与下丘脑-垂体--肾上腺轴/甲状腺轴功能变化有关。Objective To analyze the relationship of the intestinal flora and irritable bowel syndrome sub-typing with the functional changes in the neuroendocrine axis.Methods A retrospective study was used,one hundred patients with irritable bowel syndrome in Chengdu Qingbaijiang District People's Hospital from January 2019 to February 2022 were enrolled as study group,and were classified into diarrhea type,constipation type and mixed type,meantime,another 50 healthy individuals were set as healthy group.The intestinal flora,and the functional parameters related to hypothalamic-pituitary-adrenal and-thyroid axes were detected.Then the correlation of intestinal flora and sub-typing with the functional changes in the neuroendocrine axis was discussed.Results Compared with control group,patients in study group showed a decrease in the number of Bifidobacterium and Lactobacillus,and an increase in the number of Enterobacter and Enterococcus,the differences were statistically significant(P<0.05).Among patients of different sub-types,the number of Bifidobacterium and Lactobacillus in patients of diarrhea type was higher than that in patients of constipation and mixed types,and the number of Enterobacter and Enterococcus was lower than that in patients of constipation and mixed type,the differences were statistically significant(P<0.05).Bifidobacterium,Lactobacillus,Enterobacter and Enterococcus were independent factors affecting the sub-typing of irritable bowel syndrome,the differences were statistically significant(P<0.05).Serum adrenocorticotropic hormone(ACTH)level of study group was lower than that of healthy group at 8∶00,and was higher than that of healthy group at 24∶00,the differences were statistically significant(P<0.05).Serum cortisol(COR)level at 16∶00 in study group was higher than that in healthy group,the difference was statistically significant(P<0.05).Levels of free thyroxine(FT4)and thyroid-stimulating hormone(TSH)yielded no statistical difference between two groups(P>0.05).Compared with healthy group,st

关 键 词：肠道菌群 肠易激综合征分型 神经内分泌轴功能 相关性 

分 类 号：R574[医药卫生—消化系统]