肠易激综合征患者肠道菌群的变化及意义

目的了解肠易激综合征(IBS)患者肠道菌群变化情况并探讨其意义。方法选取符合罗马Ⅲ标准的50例IBS患者和体检中心25例健康志愿者,采集新鲜粪便标本应用光冈法对肠道厌氧菌双歧杆菌、乳杆菌、拟杆菌和2种常见的需氧菌肠杆菌、肠球菌分别进行定性定量培养,同时计算肠道定值抗力B/E值。结果与对照组相比,IBS组肠杆菌明显增加(P<0.05),双歧杆菌和乳杆菌均明显减少(P<0.05),B/E值明显减低(P<0.05);而肠球菌和拟杆菌差异无统计学意义。不同亚型IBS与对照组相比,腹泻型IBS肠杆菌明显增加,双歧杆菌、乳杆菌及B/E值均明显减低(P<0.05);便秘型IBS拟杆菌明显增加(P<0.05),其他无统计学意义;交替型IBS肠杆菌明显增加(P<0.05),乳杆菌及B/E值明显减低(P<0.05)。结论 IBS患者存在肠道菌群的失调,表现为肠道定值抗力受损,肠杆菌增加,双歧杆菌和乳杆菌减少。不同亚型IBS存在不同的肠道菌群变化。

The changes and significances of intestinal microflora in patients with irritable bowel syndrome

Objective To investigate the changes of irritable bowel syndrome(IBS) intestinal microflorain patients,and explored the significances.Methods Fifty RomeⅢ criteria IBS patients and twenty-five healthy subjects were enrolled,fresh faecal samples were collected and the method established by Mit-suoka was used to quantitatively and qualitatively culture the fecal three kinds of anaerobes(Bifidobacterium,Lactobacillus,Bacteroides) and two kinds of aerobes(Enterobacteriaceae,Enterococcus).We also calculated the ratio of Bifidobacterium to Enterobacteriaceae(B/E value).Results Compared with healthy subjects,the number of fecal Enterobacteriaceae was significantly increased(P < 0.05),Bifidobacterium,Lactobacillus and B / E value were significantly decreased in IBS patients(P < 0.05),but the number of Bacteroides and Enterococcus were not significantly.Different types of IBS had dif ferent changes of intestinal microflora,the number of fecal Enterobacteriaceae was significantly increased,the number of fecal Bifidobacterium,Lactobacillus and B / E value were significantly decreased in diarrhea-predominant IBS patients versus healthy subjects(P < 0.05);compare with healthy subjects the level of fecal Bacteroides was significantly increased in constipation-predominant IBS(P < 0.05),others were not significantly;compared with healthy subjects,the level of fecal Enterobacteriaceae was significantly increased,Lactobacillus and B / E value were significantly decreased in alterlated-predominant IBS patients(P < 0.05).Conclusion There are intestinal microflora disorders in IBS patients,B / E value is less than 1,the numbers of Enterobacteriaceae are significantly increased,the numbers of Bifidobacterium and Lactobacillus are significantly decreased.Different types of IBS have different changes of intestinal flora.