溃疡性结肠炎患者肠道菌群失调与H.pylori感染和DAI评分及免疫球蛋白水平的相关性  

Correlation between intestinal flora imbalance and H.pylori infection,DAI score,immunoglobulins in patients with ulcerative colitis

作　　者：顾晓霞 高振军 GU Xiao-xia;GAO Zhen-jun(Qingpu District Zhujiajiao People's Hospital,Shanghai 201703,China;不详)

机构地区：[1]上海市青浦区朱家角人民医院,上海201703 [2]复旦大学附属中山医院青浦分院

出　　处：《中国微生态学杂志》2023年第3期348-352,共5页Chinese Journal of Microecology

摘　　要：目的探讨溃疡性结肠炎(UC)患者肠道菌群失调与幽门螺杆菌(H.pylori)感染、疾病活动指数(DAI)评分和免疫球蛋白的相关性。方法选取2019年6月至2021年6月在我院确诊的97例UC患者作为观察组,根据肠道菌群失调程度将患者分为Ⅰ度组(34例)、Ⅱ度组(38例)、Ⅲ组(25例),另同期随机选取在我院进行健康体检的健康者97例作为对照组。采用微生物鉴定系统检测并比较所有患者肠道肠球菌、双歧杆菌、乳杆菌及大肠埃希菌的数量;采用14C尿素呼气试验检查并比较所有患者H.pylori感染情况;采用DAI评分比较所有患者的疾病活动情况;采用免疫散射比浊法检测患者的免疫球蛋白(IgA、IgG、IgM)水平;采用Pearson相关性分析研究UC患者肠道菌群与DAI评分及免疫球蛋白的关系。结果Ⅰ度组和Ⅱ度组患者H.pylori阳性率分别为50.00%和31.58%,均显著高于Ⅲ度组的20.00%(χ^(2)=6.026,P=0.049)。Ⅰ度组、Ⅱ度组、Ⅲ度组患者肠道肠球菌、大肠埃希菌数量多于对照组,双歧杆菌、乳杆菌的数量少于对照组(均P<0.05),且相较于Ⅰ度组,Ⅱ度组、Ⅲ度组患者肠道肠球菌、大肠埃希菌数量更多,双歧杆菌、乳杆菌的数量更少(均P<0.05)。Ⅰ度组、Ⅱ度组、Ⅲ度组患者的DAI评分、IgA、IgG水平显著高于对照组,IgM水平低于对照组(均P<0.05);且相较于Ⅰ度组,Ⅱ度组、Ⅲ度组患者的DAI评分、IgA、IgG水平更高,IgM水平更低(均P<0.05)。UC患者肠道肠球菌、大肠埃希菌数量与H.pylori感染、IgM水平呈负相关(r=−0.252、−0.242、−0.757、−0.346,均P<0.05),与DAI评分、IgA和IgG水平呈正相关(r=0.328、0.289、0.292、0.222、0.335、0.312,均P<0.05)。UC患者肠道双歧杆菌、乳杆菌数量与H.pylori感染、IgM水平呈正相关(r=0.221、0.344、0.215、0.231,均P<0.05),与DAI评分、IgA和IgG水平呈负相关(r=−0.223、−0.277、−0.757、−0.252、−0.242、−0.284,均P<0.05)。结论UC患者肠道Objective To explore the correlation between intestinal flora imbalance and Helicobacter pylori(H.pylori)infection,score of disease activity index(DAI),immunoglobulins in patients with ulcerative colitis(UC).Methods A total of 97 patients with UC confirmed in the hospital were enrolled as observation group between June 2019 and June 2021.According to the severity of intestinal flora imbalance,they were divided into degreeⅠgroup(34 cases),degreeⅡgroup(38 cases)and degreeⅢgroup(25 cases).A total of 97 healthy controls during the same period were randomly enrolled as control group.The counts of Enterococci,Bifidobacteria,Lactobacillus and Escherichia coli in all patients were detected and compared by microbial identification system.H.pylori infection in all patients was detected and compared by 14C urea breath test.The disease activity in all patients was compared by DAI scores.The levels of immunoglobulins(IgA,IgG,IgM)were detected by immune scatter turbidity.The relationship between intestinal flora and DAI score,immunoglobulins was analyzed by Pearson correlation analysis.Results The positive rates of H.pylori infection in degreeⅠgroup and degreeⅡgroup were 50.00%and 31.58%,significantly higher than 20.00%in degreeⅢgroup(χ2=6.026,P=0.049).The counts of Enterococci and Escherichia coli in degreeⅠgroup,degreeⅡgroup and degreeⅢgroup were more than those in control group,while counts of Bifidobacteria and Lactobacillus were fewer than those in control group(all P<0.05).Compared with degreeⅠgroup,counts of Enterococci and Escherichia coli were more,while counts of Bifidobacteria and Lactobacillus were fewer in degreeⅡgroup and degreeⅢgroup(all P<0.05).DAI score,levels of IgA and IgG in degreeⅠgroup,degreeⅡgroup and degreeⅢgroup were significantly higher than those in control group,while IgM level was lower than that in control group(all P<0.05).Compared with degreeⅠgroup,DAI score,levels of IgA and IgG were higher,while IgM level was lower in degreeⅡgroup and degreeⅢgroup(P<0.05).T

关 键 词：溃疡性结肠炎 肠道菌群失调 幽门螺杆菌感染 疾病活动指数 免疫球蛋白 

分 类 号：R574.62[医药卫生—消化系统]