老年2型糖尿病患者肠道菌群的变化分析

目的肠道菌群的稳定与否不仅在维持人体正常生理功能中发挥重要作用，而且往往与某些疾病密切相关。通过了解本地区老年2型糖尿病患者肠道菌群变化情况，并分析不同生活方式对其的影响，为更全面控制该病奠定基础。方法收集220例2型糖尿病患者（纳入标准符合2010年美国糖尿病协会诊断标准）和120例健康人群的新鲜粪便，利用稀释平板计数法和快速细菌鉴定法对双歧杆菌、肠杆菌科细菌、拟杆菌、乳酸杆菌、肠球菌和酵母菌进行定性、定量分析。结果老年糖尿病患者的肠道菌群中双歧杆菌显著减少（t=17．266，P〈0．05），肠球菌和大肠杆菌显著增多（t=7．690，P〈0．05；t=20．885，P〈0．05）。抗生素对老年糖尿病患者肠道菌群均有影响，主要受影响的细菌为益生菌菌群，其中又以亚胺培南和第3代头孢菌素的影响较大。日常生活习惯中，吸烟、饮用白酒显著减少肠道益生菌的数量（吸烟：双歧杆菌t=22．141，P〈0．05，乳酸杆菌t=18．502，P〈0．05；饮酒：双歧杆菌F=244．343，P〈0．05，乳酸杆菌F=657．400，P〈0．05），而高纤维膳食则利于肠道益生菌的生长（双歧杆菌t=13．787，P〈0．05，乳酸杆菌t=15．754，P〈0．05）。结论在老年糖尿病患者的治疗中，除控制血糖外，采用一系列措施（如合理使用抗生素、增加膳食纤维的摄入以及戒烟限酒等）恢复肠道菌群也至关重要，有助于提高糖尿病的防治水平。

Investigation of intestinal flora situation of elderly patients with type 2 diabetes

Objective Gut flora homeostasis not only plays important roles in maintain normal physiological functions of intestines, but often closely related to certain diseases. This study was conducted to investigate intestinal flora situation of elderly patients with diabetes, and analyze the impact of different lifestyles on them, which could lay a foundation to im- prove the treatment of diabetes. Methods 220 cases of type 2 diabetes and 120 cases of normal population were included in this survey. Bifidobacterium, Enterobacteriaceae, Bacteroides, Laetobacillus, Enterocoecus and yeasts were analyzed qualitative and quantitative using dilution plate count method and rapid bacterial identification method. Results Intesti- nal flora composition of elderly patients with diabetes was altered. The content of Bifidobacteria decreased significantly （ t = 17. 266,P 〈 0.05 ）, while enterocoeci and Escherichia coli increased significantly （ t = 7. 690,P 〈 0.05 ; t = 20. 885, P 〈 0.05 ）. Intestinal microflora of elderly diabetic patients was affected by antibiotics, mainly affected bacteria was probi- otic flora. The impact of imipenem and the third-generation cephalosporins on probiotic flora were significantly greater than others. Daily habits such as smoking, drinking liquor significantly reduce the number of probiotics （ For smoking： Bifidobac- terium t = 22.141, P 〈 0.05, Lactobaeillus t = 18. 502, P 〈 0.05 ; Drinking ： Bifidobacterium F = 244. 343, P 〈 0.05, Lac- tobaeillus F = 657. 400, P 〈 0.05 ）, and the high fiber diet is beneficial to the growth of probioties （ Bifidobacteria t = 13. 787, P 〈 0.05, Lactobacillus t = 15. 754, P 〈 0.05 ）. Conclusion In the treatment of elderly patients with diabetes,in addition to controlling blood sugar, the adoption of a series of measures（ such as the rational use of antibiotics, increasing dietary fiber intake and quit alcohol limit,etc. ） to restore intestinal flora was also essential to help improve the level of prevention and treatment diabetes.