老年真菌性肺炎肠道微生物菌群分布及其与血清IL-6、SAA、PCT的相关性  

Distribution of intestinal floras and their correlation with serum IL-6,SAA and PCT in the elderly with fungal pneumonia

作　　者：张蕾 田家强 ZHANG Lei;TIAN Jia-qiang(Laboratory Department of Zaozhuang Central Hospital of Shandong Health Group,Shandong Zaozhuang 277000)

机构地区：[1]山东健康集团枣庄中心医院检验科,山东枣庄277000 [2]山东省枣庄市中心血站,山东枣庄277101

出　　处：《医学检验与临床》2023年第12期31-35,共5页Medical Laboratory Science and Clinics

摘　　要：目的:探讨老年真菌性肺炎肠道微生物菌群分布及其与血清白细胞介素(IL)-6、血清淀粉样蛋白A(SAA)、降钙素原(PCT)的相关性。方法:选取2020年3月-2022年6月在本院收治的老年肺炎患者196例,根据不同感染类别将其分为真菌性肺炎组(n=78)和非真菌性肺炎组(n=118),采用微生物鉴定系统检测患者肠道微生菌群分布情况。根据真菌性肺炎患者肠道菌群失调程度将其分为I度组(n=29)、Ⅱ度组(n=26)、Ⅲ组(n=23),比较不同菌群失调程度患者的血清IL-6、SAA、PCT水平和T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+));采用Spearman相关性分析老年真菌性肺炎患者肠道微生物菌群失调程度与血清IL-6、SAA、PCT及T淋巴细胞亚群的相关性。结果:真菌性肺炎组患者双歧杆菌数目和双歧杆菌菌落数/肠杆菌菌落数值(B/E)低于非真菌性肺炎组,肠杆菌数目高于非真菌性肺炎组(P<0.05),两组乳杆菌、梭杆菌和肠球菌数目比较无明显差异(P>0.05)。Ⅱ度组、Ⅲ度组患者血清IL-6、SAA、PCT水平均高于I度组(P<0.05),且Ⅱ度组、Ⅲ度组患者依次升高(P<0.05)。ⅡI度组、Ⅲ度组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均低于I度组,CD8^(+)高于I度组(P<0.05),且相较于Ⅱ度组,Ⅲ度组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)更低,CD8^(+)更高(P<0.05)。Spearman相关性显示,肠道菌群失调程度与血清IL-6、SAA、PCT和CD8^(+)肠道菌群失调程度均呈正相关(r=0.574、0.437、0.517、0.289,P均<0.05),与CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均呈负相关(r=-0.368、-0.698、-0.284,P均<0.05)。结论:老年真菌性肺炎患者存在肠道微生物菌群失衡,表现为双歧杆菌减少,肠杆菌增多。且老年真菌性肺炎患者肠道微生物菌群失调程度与血清IL-6、SAA、PCT水平密切相关。Objective:To explore the distribution of intestinal floras and their correlation with serum interleukin(IL)-6,serum amyloid A(SAA)and procalcitonin(PCT)in the elderly with fungal pneumonia.Methods:A total of 196 elderly patients with pneumonia admitted to the hospital were enrolled between March 2020 and June 2022.According to different types of infection,they were divided into fungal pneumonia group(n=78)and non-fungal pneumonia group(n=118).The distribution ofintestinal floras was detected by microbial identification system,According to the severity of intestinal flora disorder,patients with fungal pneumonia were divided into group I(n=29),group I(n=26)and group II(n=23),and levels of serum IL-6,SAA,PCT and T lymphocyte subsets(CD3^(+),CD4t,CD8^(+),CD4^(+)/CD8t)were compared among the three groups.The correlation between the severity of intestinal flora disorder and serum IL-6,SAA,PCT,T lymphocyte subsets was analyzed by Spearman correlation analysis.Results:The count of Bifidobacteria and Bifidobacterium colony number/enterobacterium colony number(B/E)in fungal pneumonia group were lower than those in non-fungal pneumonia group,while count of Enterobacteria was higher than that in non-fungal pneumonia group(P<0.05).There was no significant diference in counts of Lactobacill,Clostridium and Enterococcus between the two groups(P>0.05).The levels of serum IL-6,SAA and PCT were the highest in group III fllowed by group II and group I(P<0.05).CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were the highest in group I,followed by group II and group III,while CD8^(+)was on the contrary(P<0.05).Spearman correlation analysis showed that the severity of intestinal flora disorder was positively correlated with serum IL-6,SAA,PCT and CD8^(+)(r=0.574,0.437,0.517,0.289,P<0.05),while negatively correlated with CD3t,CD4^(+)and CD4^(+)/CD8^(+)(r=-0.368,-0.698,-0.284,P<0.05).Conclusion:There is imbalance of intestinal floras in elderly patients with fungal pneumonia,including decreased Bifidobacteria and increased Enterobacteria.Moreover,the

关 键 词：真菌性肺炎 肠道微生物菌群 白细胞介素-6 血清淀粉样蛋白A 降钙素原 

分 类 号：R446[医药卫生—诊断学]