肠道菌群失衡与腹膜透析患者血清炎性因子的相关性及对患者预后的影响  

The correlation between intestinal microecological imbalance and serum inflammatory factors and its potential effect on the prognosis of patients with peritoneal dialysis

作　　者：李玉霞 赵子娜 李江花 王玉慧[3] 李国龙 LI Yu-xia;ZHAO Zi-na;LI Jiang-hua;WANG Yu-hui;LI Guo-long(Department of Nephrology,Hebei General Hospital for Veterans,Xingtai,Hebei 054000,China;不详)

机构地区：[1]河北省退役军人总医院肾内科,河北邢台054000 [2]河北省退役军人总医院护理部 [3]承德市中心医院血液透析室

出　　处：《中国微生态学杂志》2022年第9期1066-1070,共5页Chinese Journal of Microecology

基　　金：河北省2020年度医学科学研究课题项目(20200346)。

摘　　要：目的 探讨肠道菌群失衡与腹膜透析患者血清炎性因子的相关性并监测患者的预后。方法 选择2017年12月至2020年12月来我院治疗的140例腹膜透析患者为腹膜透析组;另纳入140例健康体检者作为健康体检组。比较两组对象血清炎性因子[白介素(IL)-6、IL-8、IL-13、IL-18]水平和肠道菌群(双歧杆菌、乳杆菌、肠杆菌、肠球菌)数量,分析肠道菌群与血清炎性因子和预后的相关性。结果 腹膜透析组患者血清IL-6、IL-8、IL-18水平分别为(30.21±1.22)ng/mL、(69.12±10.22)ng/mL、(138.47±19.28)ng/mL,均高于健康体检组;而IL-13的水平为(16.47±1.24)ng/mL,显著低于健康体检组,差异有统计学意义(均P<0.05)。腹膜透析组患者粪便标本中双歧杆菌和乳杆菌数量为(6.67±1.24)lg CFU/g、(6.41±1.04)lg CFU/g,均显著低于健康体检组;而肠杆菌和肠球菌数量为(9.15±0.32)lg CFU/g、(7.63±1.54)lg CFU/g,均高于健康体检组,差异有统计学意义(均P<0.05)。腹膜透析患者血清IL-6、IL-8、IL-18与双歧杆菌、乳杆菌数量呈负相关,与肠杆菌和肠球菌呈正相关;血清IL-13与双歧杆菌和乳杆菌数量呈正相关,与肠球菌和肠杆菌呈负相关,差异均有统计学意义(均P<0.05)。随访半年,140例腹膜透析患者中28例复发腹膜炎,复发者血清IL-6、IL-8、IL-18水平显著高于未复发者,IL-13水平显著低于未复发者,差异均有统计学意义(均P<0.05)。腹膜炎复发者肠道肠杆菌和肠球菌水平显著高于未复发者(均P<0.05),而乳杆菌和双歧杆菌无显著区别(均P>0.05)。结论 腹膜透析患者血清炎性因子水平较高,肠道益生菌减少,致病菌增加;肠道菌群数量与血清炎性因子水平密切相关,二者水平的变化能提示疾病的进展,为腹膜透析患者预后监测提供依据。Objective To explore the relationship between intestinal microecological imbalance and serum inflammatory factors in peritoneal dialysis(PD)patients for monitoring the prognosis of patients.Method A total of 140 PD patients treated in our hospital from December 2017 to December 2020 were selected as the PD group,with 140 healthy individuals as the healthy control group.The levels of serum inflammatory factors[Interleukin(IL)-6,IL-8,IL-13 and IL-18]and intestinal flora(Bifidobacterium,Lactobacillus,Enterobacter and Enterococcus)in two groups were compared.The correlation between intestinal flora and serum inflammatory factors and prognosis were analyzed.Results The levels of serum IL-6,IL-8 and IL-18 in PD group were(30.21±1.22)ng/mL,(69.12±10.22)ng/mL and(138.47±19.28)ng/mL,higher than those in the control group,while the level of IL-13 was(16.47±1.24)ng/mL,significantly lower than that in the control group(all P<0.05).The counts of Bifidobacterium and Lactobacillus in stool of PD group were(6.67±1.24)lg CFU/g and(6.41±1.04)lg CFU/g,significantly lower than those in the healthy control group,while the counts of Enterobacter and Enterococcus were(9.15±0.32)lg CFU/g and(7.63±1.54)lg CFU/g,higher than in the healthy control group(all P<0.05).In PD patients,the levels of serum IL-6,IL-8 and IL-18 were negatively correlated with the content of Bifidobacterium and Lactobacillus,and positively correlated with Enterobacter and Enterococcus.IL-13 level was positively correlated with the content of Bifidobacterium and Lactobacllus and negatively correlated with Enterococcus and Enterobacter,all with statistically significant differences(all P<0.05).After followed up for half a year,among the 140 PD patients,28 had recurrent peritonitis,and their levels of IL-6,IL-8 and IL-18 were significantly higher,while the IL-13 level was significantly lower than those of non-relapsed patients respectively(all P<0.05).The levels of Enterobacter and Enterococcus in patients with relapsed peritonitis were significantly higher tha

关 键 词：肠道微生态失衡 腹膜透析 血清炎性因子 相关性 预后 

分 类 号：R446.1[医药卫生—诊断学]