CAJ | 학술논문

目的：探讨溃疡性结肠炎患者肠道菌群改变与炎性指标的相关性。方法收集自2011年1月至2013年7月我院诊断为溃疡性结肠炎患者94例，并按照入组时疾病状态分为活动期组62例和缓解期组32例，与同期健康查体对照组50例进行大便菌群结构和细菌数量比较，同时检查三组人群中的内毒素、TNF-α、IL-6、IL-10、IL-4水平并分析这些炎性指标与菌群变化的相关性。结果与缓解期组和对照组比较，发作期组双歧杆菌、乳酸杆菌、真杆菌、消化球菌数量明显较少，肠杆菌、肠球菌和小梭菌菌群数量明显增多，差异均有统计学意义(P<0.05)；三组中酵母菌菌群数量比较，差异无统计学意义(P>0.05)。溃疡性结肠炎患者活动期组的内毒素、TNF-α、IL-6水平明显高于对照组和缓解期组，而IL-4和IL-10水平明显低于对照组和缓解期组，差异均有统计学意义(P<0.05)。内毒素及TNF-α与双歧杆菌数量呈负相关，与肠杆菌呈正相关；IL-6与乳酸杆菌、真杆菌呈负相关，与肠球菌呈正相关；IL-4与小梭菌呈负相关，与双歧杆菌呈正相关；IL-10与消化球菌呈正相关。结论溃疡性结肠炎患者正常菌群结构被破坏，体内促炎因子分泌增加，抑炎因子水平下降。
목적：탐토궤양성결장염환자장도균군개변여염성지표적상관성。방법수집자2011년1월지2013년7월아원진단위궤양성결장염환자94례，병안조입조시질병상태분위활동기조62례화완해기조32례，여동기건강사체대조조50례진행대편균군결구화세균수량비교，동시검사삼조인군중적내독소、TNF-α、IL-6、IL-10、IL-4수평병분석저사염성지표여균군변화적상관성。결과여완해기조화대조조비교，발작기조쌍기간균、유산간균、진간균、소화구균수량명현교소，장간균、장구균화소사균균군수량명현증다，차이균유통계학의의(P<0.05)；삼조중효모균균군수량비교，차이무통계학의의(P>0.05)。궤양성결장염환자활동기조적내독소、TNF-α、IL-6수평명현고우대조조화완해기조，이IL-4화IL-10수평명현저우대조조화완해기조，차이균유통계학의의(P<0.05)。내독소급TNF-α여쌍기간균수량정부상관，여장간균정정상관；IL-6여유산간균、진간균정부상관，여장구균정정상관；IL-4여소사균정부상관，여쌍기간균정정상관；IL-10여소화구균정정상관。결론궤양성결장염환자정상균군결구피파배，체내촉염인자분비증가，억염인자수평하강。
Objective To investigate the correlation between inflammatory indicators and changes of fecal florain in patients with ulcerative colitis (UC). Methods Fresh fecal specimens from 94 UC patients (including of 62 cases in active period and 32 cases in remission period) and 50 healthy volunteers were collected in our hospital from January 2011 to July 2013. The fecal flora and the levels of inflammatory indicators including of endotoxin, TNF-α, IL-6, IL-10 and IL-4 were examined to analyze the correlation between the fecal flora and the inflammatory indica-tors. Results Compared with those in remission UC patients and healthy controls, the number of Bifidobacterium, Lactobacillus, Eubacterium and Peptococcus significantly decreased (P<0.05), but the number of Enterrococcus, En-terobacterium and Clostridium significantly increased (P<0.05), in the active UC patients. The number of Saccharomy-ces was not significantly different among three groups. Compared with remission UC patients and healthy control, the active UC patients had significantly higher levels of endotoxin, TNF-αand IL-6, but lower levels of IL-10 and IL-4 (P<0.05). Endotoxin and TNF-αwas negatively correlated with Bifidobacterium but positively correlated with Entero-bacterium. IL-6 was negatively correlated with Lactobacillus and Eubacterium but positively correlated with Enterro-coccus. IL-4 was negatively correlated with Clostridium but positively correlated with Bifidobacterium. IL-10 was positively correlated with Peptococcus. Conclusion UC patients have fecal flora imbalance, with the increasing of inflammatory cytokines and decreasing of anti-inflammatory cytokines.