肠道细菌感染与炎症性肠病的关系

目的观察肠道细菌在炎症性肠病（inflammatory bowel disease,IBD）患者和健康者中的表达差异,分析肠道细菌感染与炎症性肠病的关系。方法收集经过内镜检查及病理报告确诊的100例克罗恩病（Crohn＇s disease,CD）患者,80例溃疡性结肠炎（ulcerative colitis,UC）和80例健康者的粪便及血清样本,PCR法和酶联免疫吸附试验对难辨梭状芽孢杆菌（Cd）、沙门氏菌（Sm）和金黄色葡萄球菌（Sa）的表达进行检测。结果 IBD患者中Cd、Sm和Sa的感染率分别为10.6%、8.3%和7.8%,显著高于健康组（P=0.003,0.018,0.023）;活动期CD和UC患者Cd、Sm和Sa的感染率均显著高于缓解期患者（P=0.008,0.022;P=0.025,0.011;P=0.025,0.021）,CD和UC患者的细菌感染率差异无统计学意义（P〉0.05）。IBD患者病变部位包含结肠、使用激素及免疫制剂治疗,与上述3种细菌的感染有显著关联（P〈0.05）,而吸烟史及使用美沙拉嗪治疗与细菌感染无显著关联（P〉0.05）。结论本研究结果提示肠道细菌感染与炎症性肠病关系密切。

Relationship between intestinal bacterial infection and inflammatory bowel diseases

Objective To investigate the relationship between intestinal bacterial infection and inflammatory bowel diseases （IBD）. Methods Stool and serum samples were collected from 100 patients with Crohn＇s disease （CD）, 80 patients with ulcerative colitis （UC） and 80 healthy subjects. CD and UC were diagnosed by endoscopic and pathological examinations. Clostridium difficile （Cd）, salmonella （Sm） and staphylococcus aureus （Sa） were detected by PCR and ELISA in all stool samples. Results The infection rate of Cd, Sm and Sa in IBD patients was 10.6%, 8.3% and 7. 8%, respectively, which were significant higher than that in healthy controls（P =0. 003, 0. 018, 0. 023 ）. The infection rate of Cd, Sm and Sa in patients with active CD or UC were higher than that in remission patients （ P = 0. 008 and 0. 022 ; P = 0. 025 and 0.011 ; P = 0. 025 and 0. 021 ）. There was no significant difference in infection rate between CD and UC patients （ P 〉 0.05 ）. Intestinal bacterial infection was closely associated with colonic involvement and prednisone or immunos- uppressor use （P 〈 0.05）, not associated with smoking history and mesalazine use （ P 〉 0.05 ）. Conclusion These results suggest that intestinal bacterial infection is closely associated with inflammatory bowel disease.