炎症性肠病患者重点肠道菌群特征及危险因素分析  

Analysis of key gut microbiota characteristics and risk factors in patients with inflammatory bowel disease

作　　者：何武 曹斌 张家友 HE Wu;CAO Bin;ZHANG Jiayou(Department of Internal Medicine,Ganzi Tibetan Autonomous Prefecture Health School Affiliated Hospital,Ganzi 626001,Sichuan,China;Department of Medical Records,Ganzi Tibetan Autonomous Prefecture Health School Affiliated Hospital;Department of Hematology and Rheumatology,the Second Affiliated Hospital of Chengdu Medical College,416 Hospital of Nuclear Industry)

机构地区：[1]甘孜藏族自治州卫生学校附属医院内科,四川甘孜626001 [2]甘孜藏族自治州卫生学校附属医院病案科,四川甘孜626001 [3]成都医学院第二附属医院核工业四一六医院血液风湿科

出　　处：《中国病原生物学杂志》2025年第5期647-650,655,共5页Journal of Pathogen Biology

摘　　要：目的本研究旨在探讨炎症性肠病(IBD)患者与健康对照组在肠道菌群特征及危险因素方面的差异,以期为IBD的发病机制提供新的见解,并为临床防治提供参考。方法本研究为回顾性研究,纳入了2022-2023年本院内科门诊确诊为IBD的患者80例,选取同期健康人群80例为对照。收集两组人群的基本资料,包括年龄、性别、身体质量指数(BMI)、糖尿病及高血压病史等,并记录了可能的危险因素,如家族病史、吸烟史、非甾体抗炎药(NSAIDs)使用情况、高脂饮食习惯、抗生素使用史等。同时,采集了每位参与者的新鲜粪便样本,采用梯度稀释法对样本中的肠道菌群进行培养,检测两组大肠埃希菌、双歧杆菌、乳酸杆菌、脆弱拟杆菌及肠球菌的数量。结果IBD患者与健康对照组在年龄、性别、BMI等方面无显著差异。在肠道菌群方面,IBD患者的大肠埃希菌数量显著高于健康对照组(P=0.002),而双歧杆菌和乳酸杆菌的数量则显著低于对照组(P<0.05)。脆弱拟杆菌和肠球菌在IBD患者中的数量也有所增加(P=0.028)。单因素分析显示,NSAIDs使用(P=0.006)、高脂饮食(P<0.001)和抗生素使用史(P=0.003)是IBD的重要危险因素。多因素分析进一步证实,经校正后,NSAIDs使用(Adj OR=3.53,95%CI:1.41-8.61,P=0.007)、高脂饮食(Adj OR=2.04,95%CI:1.21-3.45,P=0.01)和抗生素使用史(Adj OR=2.52,95%CI:1.22-5.43,P=0.03)是IBD发病的独立危险因素。此外,大肠埃希菌数量增加(Adj OR=1.81,95%CI:1.12-3.01,P=0.02)和乳酸杆菌数量减少(Adj OR=0.53,95%CI:0.34-0.75,P<0.001)也与IBD发病显著相关。结论IBD患者的肠道菌群特征存在明显差异,特别是大肠埃希菌数量增加和乳酸杆菌数量减少。此外,NSAIDs使用、高脂饮食习惯和抗生素使用史是IBD的重要危险因素。这些发现提示调节肠道菌群和控制相关危险因素可能有助于IBD的预防和治疗。Objective This study aims to explore the differences in gut microbiota characteristics and risk factors between patients with inflammatory bowel disease(IBD)and a healthy control group,providing new insights into the pathogenesis of IBD and offering guidance for clinical prevention and treatment.Methods This was a retrospective study that included 80 patients diagnosed with IBD at the internal medicine outpatient clinic of our hospital between 2022 and 2023.Additionally,80 healthy individuals from the same period were selected as controls.Basic information,including age,gender,body mass index(BMI),history of diabetes and hypertension,and potential risk factors such as family history,smoking history,non-steroidal anti-inflammatory drug(NSAIDs)use,high-fat diet habits,and antibiotic use history,were collected from both groups.Fresh fecal samples were collected from each participant,and the gut microbiota in the samples were cultured using the gradient dilution method to detect the quantities of Escherichia coli,Bifidobacterium,Lactobacillus,Bacteroides fragilis,and Enterococcus in both groups.Results There were no significant differences in age,gender,or BMI between the IBD patients and the healthy control group.In terms of gut microbiota,the quantity of E.coli was significantly higher in IBD patients than in the control group(P=0.002),while the quantities of Bifidobacterium and Lactobacillus were significantly lower(P<0.05).The quantities of Bacteroides fragilis and Enterococcus were also increased in IBD patients(P=0.028).Univariate analysis showed that NSAIDs use(P=0.006),a high-fat diet(P<0.001),and a history of antibiotic use(P=0.003)were important risk factors for IBD.Multivariate analysis further confirmed that,after adjustment,NSAIDs use(Adjusted OR=3.53,95%CI:1.41-8.61,P=0.007),a high-fat diet(Adjusted OR=2.04,95%CI:1.21-3.45,P=0.01),and a history of antibiotic use(Adjusted OR=2.52,95%CI:1.22-5.43,P=0.03)were independent risk factors for the development of IBD.Additionally,an increased quantity of E.coli(A

关 键 词：炎症性肠病 肠道菌群 危险因素 

分 类 号：R574[医药卫生—消化系统]