IBS患者神经内分泌轴功能与肠道菌群、炎症反应及胃肠症状的相关性  

Correlation of neuroendocrine axis function with intestinal flora,inflammatory reaction and gastrointestinal symptoms in patients with IBS

作　　者：徐菁 刘坤 马竹芳 XU Jing;LIU Kun;MA Zhu-fang(Department of Gastroenterology,3201 Hospital,Hanzhong Shaanxi 723000,China)

机构地区：[1]三二〇一医院消化内科,陕西汉中723000

出　　处：《临床和实验医学杂志》2023年第4期360-364,共5页Journal of Clinical and Experimental Medicine

基　　金：陕西省重点研发计划项目(编号:2021SF-244)。

摘　　要：目的探讨肠易激综合征(IBS)患者神经内分泌轴功能与肠道菌群、炎症反应及胃肠症状的相关性。方法采用前瞻性研究方法,选取2021年1月至2022年8月在三二〇一医院治疗的IBS患者108例(IBS组),其中腹泻型患者67例,便秘型患者41例,同时纳入健康志愿者108名作为对照组。比较IBS组和对照组的促肾上腺皮质激素(ACTH)和皮质醇水平以及肠道菌群、炎症因子差异,分析腹泻型和便秘型IBS患者ACTH、皮质醇、肠道菌群、炎症因子及胃肠症状差异,并分析IBS组ACTH、皮质醇与肠道菌群、炎症因子、肠易激综合征症状严重程度量表(IBS-SSS)总分的相关性。结果IBS组ACTH、皮质醇、肠杆菌、白细胞介素(IL)-6、IL-8分别为(15.10±3.12)pg/mL、(190.29±32.10)ng/mL、(8.83±0.67)lgCFU/g、(20.33±7.54)ng/L和(51.12±16.65)ng/L,均明显高于对照组,而双歧杆菌、乳杆菌、类杆菌、拟杆菌和IL-10分别为(8.01±0.82)lgCFU/g、(6.02±0.55)lgCFU/g、(9.10±0.88)lgCFU/g、(8.21±0.56)lgCFU/g和(23.32±7.21)ng/L,均明显低于对照组,差异均有统计学意义(P<0.05)。IBS组腹泻型患者ACTH、皮质醇、肠杆菌、IL-8均明显高于便秘型患者,而双歧杆菌、乳杆菌、类杆菌、拟杆菌、IL-10均明显低于便秘型患者,差异均有统计学意义(P<0.05)。IBS组腹泻型和便秘型患者IBS-SSS量表腹痛程度、腹痛时间、腹胀情况、排便满意度、生活干扰程度、总分比较,差异均无统计学意义(P>0.05)。ACTH、皮质醇与双歧杆菌、乳杆菌、类杆菌、拟杆菌呈负相关(P<0.05),与肠杆菌、IL-6、IL-8、IL-10和IBS-SSS总分呈正相关(P<0.05)。结论IBS患者神经内分泌轴功能紊乱、肠道菌群失调、炎症反应水平升高,其中神经内分泌轴功能与肠道菌群、炎症反应及胃肠症状有关,值得进一步研究。Objective To explore the relationship between the function of neuroendocrine axis and intestinal flora,inflammatory reaction and gastrointestinal symptoms in patients with irritable bowel syndrome(IBS).Methods Using prospective research methods,a total of 108 IBS patients(IBS group)treated in 3201 Hospital from January 2021 to August 2022 were selected,including 67 patients with diarrhea and 41 patients with constipation,and 108 healthy volunteers were included as the control group.The differences of adrenocorticotropic hormone(ACTH)and cortisol,intestinal flora and inflammatory factors in IBS group and control group were compared,the differences of ACTH,cortisol,intestinal flora,inflammatory factors and gastrointestinal symptoms in diarrhea type and constipation type IBS patients were analyzed,and the correlation between ACTH,cortisol and intestinal flora,inflammatory factors,irritable bowel syndrome symptom severity scale(IBS-SSS)total score in IBS group was analyzed.Results The ACTH,cortisol,Enterobacter,interleukin(IL)-6 and IL-8 of IBS group were(15.10±3.12)pg/mL,(190.29±32.10)ng/mL and(8.83±0.67)lgCFU/g,(20.33±7.54)ng/L and(51.12±16.65)ng/L,which were significantly higher than those of the control group,the Bifidobacterium,Lactobacillus,Bacteroid,Bacteroides and IL-10 were(8.01±0.82)lgCFU/g,(6.02±0.55)lgCFU/g,(9.10±0.88)lgCFU/g and(8.21±0.56)lgCFU/g and(23.32±7.21)ng/L,which were significantly lower than those of the control group,the differences were statistically significant(P<0.05).In IBS group,ACTH,cortisol,Enterobacter and IL-8 were significantly higher than those in constipation group,while Bifidobacterium,Lactobacillus,Bacteroid,Bacteroides and IL-10 were significantly lower than those in constipation group,the differences were statistically significant(P<0.05).In IBS group,there was no significant difference in the degree of abdominal pain,duration of abdominal pain,abdominal distension,satisfaction with defecation,life disturbance and total score of IBS-SSS scale between diarrhea type and

关 键 词：肠易激综合征 神经内分泌轴功能 肠道菌群 炎症反应 胃肠症状 

分 类 号：R574.4[医药卫生—消化系统]