轻度胃肠炎伴良性婴幼儿惊厥肠道微生物改变的研究

目的 探讨轻度胃肠炎伴良性婴幼儿惊厥(BICE)肠道微生物改变。 方法 选取2013年1月1日-2016年12月31日期间在瑞安市人民医院儿科诊治的BICE患儿45例为研究组,以2016年1月1日-2016年12月31日期间在瑞安市人民医院儿科诊治的急性轻度胃肠炎患儿45例为对照组,2组患者均行粪便轮状病毒检测和大肠杆菌、肠球菌、乳酸杆菌和双歧杆菌培养。抽空腹静脉血,测定肠黏膜屏障指标,包括二胺氧化酶(DAO)、一氧化氮(NO)和D-乳酸。 结果 研究组粪便轮状病毒阳性率(48.9%)显著高于对照组(26.7%,P<0.05)。研究组粪便大肠杆菌[(7.8±2.3)CFU/g]、肠球菌[(6.0±2.3)CFU/g]、乳酸杆菌[(4.9±1.7)CFU/g]和双歧杆菌[(5.1±1.5)CFU/g]分别低于对照组的(8.8±2.2)CFU/g、(7.3±2.8)CFU/g、(6.0±2.5)CFU/g和(5.9±1.9)CFU/g(均P<0.05)。研究组血清DAO[(9.84±4.17)U/L]、D-乳酸[(0.92±0.39)mmol/L]和NO[(126.8±48.1)μmol/L]分别高于对照组的(7.49±2.73)U/L、(0.73±0.25)mmol/L和(102.4±40.5)μmol/L(均P<0.05)。 结论 轮状病毒与BICE的发病关系密切,BICE患儿肠道内益生菌数量减少,肠黏膜屏障功能下降,补充益生菌或有助于BICE的防治。 

Changes of intestinal microbiota in children with benign infantile convulsions associated with mild gastroenteritis

Objective To explore the changes of intestinal microbiota in children with benign infantile convulsions associated with mild gastroenteritis (BICE). Methods Forty-five cases of BICE diagnosed in our hospital between January, 2013 and December, 2016 were the study group. Forty-five cases of acute gastroenteritis diagnosed in our hospital between January, 2013 and December, 2016 were the control group. Fecal rotavirus was detected and Escherichia coli, Enterococcus, Lactobacillus and Bifidobacterium were cultured in the two groups. Fasting venous blood was phlebotomized and intestinal mucosal barrier indexes including diamine oxidase (DAO), nitric oxide (NO) and D-lactic acid were measured. Results The positive rate of fecal rotavirus in the study group (48.9%) was significantly higher than that in the control group(26.7%), P<0.05. The amounts of Escherichia coli[(7.8±2.3) CFU/g], Enterococcus[(6.0±2.3) CFU/g], Lactobacillus[(4.9±1.7) CFU/g] and Bifidobacteria[(5.1±1.5) CFU/g] in the study group were lower than the amounts of Escherichia coli[(8.8±2.2) CFU/g], Enterococcus[(7.3±2.8)]CFU/g, Lactobacillus[(6.0±2.5) CFU/g] and Bifidobacteria[(5.9±1.9) CFU/g]in the control group (P<0.05). The serum level of DAO[(9.84±4.17) U/L], D-lactic acid[(0.92±0.39) mmol/L] and NO[(126.8±48.1) μmol/L] in the study group were significantly higher than the serum level of DAO[(7.49±2.73) U/L], D-lactic acid[(0.73±0.25) mmol/L] and NO[(0.73±0.25) μmol/L] in the control group. Conclusion Rotavirus is closely associated with the pathogenesis of BICE. Probiotics in intestinal tract of BICE children reduce and intestinal mucosal barrier function decrease, which means supplement of probiotics may help to prevent and treat BICE.