肠道菌群结构及肺部微生物变化与慢性阻塞性肺疾病急性加重期的相关性分析  

Correlation Analysis of Intestinal Microbiota Structure and Pulmonary Microbiota Changes with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

作　　者：钟凌 熊健 沈菁[3] ZHONG Ling;XIONG Jian;SHEN Jing(Microbiological Laboratory Department,Jian’ou Center for Disease Control and Prevention,Jian’ou City,Fujian Province 353100;不详)

机构地区：[1]福建省建瓯市疾病预防控制中心微生物检验科,353100 [2]福建省建瓯市疾病预防控制中心疾病预防控制科,353100 [3]福建省建瓯市疾病预防控制中心福建省立医院检验科

出　　处：《医学理论与实践》2024年第24期4150-4153,4173,共5页The Journal of Medical Theory and Practice

摘　　要：目的:探讨肠道菌群结构及肺部微生物变化与慢性阻塞性肺疾病急性加重期(AECOPD)的相关性。方法:选取2020年1月—2023年12月80例AECOPD患者作为急性加重组,同期80例稳定期的慢性阻塞性肺疾病(COPD)患者作为稳定组,对比两组患者肠道菌群结构及肺部微生物情况。建立logistic回归模型分析肠道菌群结构及肺部微生物变化与AECOPD的关系,并采用CAT问卷评价80例AECOPD患者的疾病严重程度,将患者分为三个亚组,即轻度组(CAT为0~10分,n=23)、中度组(CAT为11~20分,n=37)及重度组(CAT为21~40分,n=20)。对比三组患者肠道菌群结构及肺部微生物变化,应用Spearman相关分析法分析肠道菌群结构及肺部微生物变化与AECOPD严重程度的相关性。结果:急性加重组乳酸杆菌、双歧杆菌、类杆菌、双歧杆菌/乳酸杆菌比值(B/E)明显低于稳定组,大肠杆菌、粪肠球菌数量明显高于稳定组(P<0.05);急性加重组共检出95株微生物,稳定组共检出13株微生物,急性加重组微生物检出数量明显高于稳定组,但两组肺部微生物类型对比无明显差异(P>0.05),急性加重组患者革兰阴性菌检出率明显高于真菌检出率与革兰阳性菌检出率(P<0.05);以急性加重作为因变量(急性加重=1,稳定=0)纳入logistic回归模型,结果表明,B/E值、革兰阴性菌感染为AECOPD的独立影响因素(P<0.05);不同疾病严重程度AECOPD患者乳酸杆菌、双歧杆菌、类杆菌、大肠杆菌、粪肠球菌、B/E值对比差异显著(P<0.05)。AECOPD患者95株微生物中,轻度组检出21株,中度组检出31株,重度组检出43株,不同疾病严重程度AECOPD患者鲍曼不动杆菌检出率对比差异显著(P<0.05);Spearman相关分析结果显示:乳酸杆菌、双歧杆菌、类杆菌、B/E值与AECOPD病情严重程度呈负相关,大肠杆菌、粪肠球菌、鲍曼不动杆菌感染与AECOPD病情严重程度呈正相关(P<0.05)。结论:肠道菌群结构对COPD患者病情急性加�Objective:To explore the correlation between the structure of intestinal microbiota and changes in pulmonary microbiota with the acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:80 patients with AECOPD from January 2020 to December 2023 were selected as acute exacerbation group,while 80 patients with chronic obstructive pulmonary disease(COPD)in stable period were selected as the stable group,and the intestinal microbiota structure and lung microbiology of the two groups were compared.Establish a logistic regression model to analyze the relationship between gut microbiota structure and pulmonary microbiota changes with AECOPD,and use the CAT questionnaire to evaluate the disease severity of 80 AECOPD patients.The patients were divided into three subgroups:mild group(CAT 0~10 points,n=23),moderate group(CAT 11~20 points,n=37),and severe group(CAT 21~40 points,n=20).Compare the gut microbiota structure and pulmonary microbiota changes among three groups of patients,and use Spearman correlation analysis to analyze the correlation between gut microbiota structure and pulmonary microbiota changes and the severity of AECOPD.Results:The recombinant Lactobacillus,Bifidobacterium,Bacteroidetes,and Bifidobacterium/Lactobacillus ratio(B/E)values in the acute exacerbation group were significantly lower than those in the stable group,while the numbers of Escherichia coli and Enterococcus faecalis in the acute exacerbation group were significantly higher than those in the stable group(P<0.05).A total of 95 strains of microorganisms were detected in the acute exacerbation group,and 13 strains were detected in the stable group.The number of microorganisms detected in the acute exacerbation group was significantly higher than that in the stable group,but there was no significant difference in lung microbial types between the two groups(P>0.05).The detection rate of Gram negative bacteria in acute exacerbation group was significantly higher than the detection rate of fungi and Gram positive bacteria(P<0.

关 键 词：肠道菌群 肺部微生物 慢性阻塞性肺疾病 急性加重期 鲍曼不动杆菌 相关性 

分 类 号：R563[医药卫生—呼吸系统]