重症急性胰腺炎患者肠道菌群和代谢产物的变化特征及其与病情的相关性  

Changes of intestinal flora and metabolites and their correlation with disease in patients with severe acute pancreatitis

作　　者：徐跃元 杨上文[1] 潘俊娣[1] XU Yue-yuan;YANG Shang-wen;PAN Jun-di(Department of Gastroenterology,Lishui Central Hospital,Lishui,Zhejiang 323000,China)

机构地区：[1]丽水市中心医院消化内科,浙江323000

出　　处：《中国微生态学杂志》2022年第11期1334-1337,共4页Chinese Journal of Microecology

摘　　要：目的 研究重症急性胰腺炎(SAP)患者肠道菌群和代谢产物的变化特征及其与病情的相关性。方法 选择2017年8月至2021年8月期间丽水市中心医院消化科收治的SAP患者作为SAP组,轻症急性胰腺炎(MAP)患者作为MAP组,同期体检的健康志愿者作为对照组。收集全部入选对象粪便标本检测肠道菌群失调情况。收集入选对象血清标本检测二胺氧化酶(DAO)、D-乳酸(D-LA)、肿瘤坏死因子-α (TNF-α)、高迁移率族蛋白B1(HMGB-1)、白介素(IL)-6、IL-8的水平。采用急性生理与慢性健康评分(APACHE-Ⅱ评分)、急性胰腺炎严重程度床边指数评分(BISAP评分)、全身炎症反应综合征评分(SIRS评分)评价SAP的病情,采用28 d生存情况评价SAP患者的短期预后。结果 SAP组的肠道菌群失调发生率及血清DAO、D-LA水平均高于对照组和MAP组(均P<0.05)。SAP组中肠道菌群失调患者的血清DAO、D-LA、TNF-α、HMGB-1、IL-6、IL-8水平及APACHE-Ⅱ评分、BISAP评分、SIRS评分、28 d累积病死率均高于肠道菌群正常患者(均P<0.05)。结论 SAP患者肠道菌群紊乱及其代谢产物的大量释放会造成病情加重、炎症反应激活及预后不良。Objective To observe the changes of intestinal flora and its metabolites in patients with severe acute pancreatitis(SAP) and their correlation with the disease. Methods SAP patients treated in the digestive department of our hospital from August 2017 to August 2021 were enrolled as SAP group, with those with mild acute pancreatitis(MAP) patients as MAP group, and healthy volunteers examined at the same time as the control group. Feces were collected for detection of the imbalance of intestinal flora. Serum was collected for detection of the levels of diamine oxidase(DAO), D-lactic acid(D-LA) and tumor necrosis factor-α(TNF-α), high mobility box protein B1(HMGB-1), interleukin(IL)-6 and IL-8. The condition of SAP was evaluated by using APACHE-Ⅱ score, BISAP score, SIRS score, and the short-term prognosis of SAP patients was evaluated by using 28 day survival. Results The incidence of intestinal flora imbalance and the levels of serum DAO and D-LA in SAP group were higher than those in control group and MAP group respectively(all P<0.05).Serum levels of DAO, D-LA, TNF-α, HMGB1, IL-6 and IL-8, APACHE-Ⅱ score, BISAP score, SIRS score, and 28 day cumulative mortality of patients with intestinal flora imbalance in SAP group were higher than those of patients with normal intestinal flora. Conclusion The disorder of intestinal flora and the release of metabolites in SAP patients will cause aggravation of the disease condition, activate inflammatory response and result in poor prognosis.

关 键 词：重症急性胰腺炎 肠道菌群 炎症反应 病情 预后 

分 类 号：R446[医药卫生—诊断学]