IBD患病人群肠道菌群分布特征及其与血清IIRPCs、MPO、CYP27B1水平的关系

目的探讨炎症性肠病(IBD)患病人群肠道菌群分布特征及其与血清免疫炎症相关蛋白复合物(IIRPCs)、髓过氧化酶(MPO)、维生素D1-α羟化酶(CYP27B1)水平的关系。方法选取2016年7月至2020年4月在该院消化科门诊和住院治疗的106例IBD患者作为病例组,其中溃疡性结肠炎(UC组)58例,克罗恩病(CD组)48例;选取同期在该院接受治疗的60例非IBD肠道疾病患者作为疾病对照组;另选取在该院同期进行结肠镜检查的60例体检健康者作为健康对照组。采集所有受试者的血清标本和新鲜粪便标本,分别进行血清IIRPCs、MPO、CYP27B1水平检测和粪便细菌培养,比较不同组研究对象的肠道菌群分布特征及血清IIRPCs、MPO、CYP27B1水平,分析其相关性。结果UC、CD组患者的肠道肠球菌、肠杆菌、消化球菌、拟杆菌、酵母菌数量较疾病对照组和健康对照组均明显增加,而乳酸杆菌、双歧杆菌、真杆菌则明显减少,差异有统计学意义(P<0.05)。106例IBD患者中,缓解期与活动期患者上述肠道菌群数量比较也存在明显差异,其中重度活动期患者与轻度、中度活动期患者比较,差异均有统计学意义(P<0.05),轻度活动期患者与中度活动期患者比较,差异无统计学意义(P>0.05)。UC、CD组血清IIRPCs、MPO、CYP27B1水平均明显高于疾病对照组和健康对照组;缓解期与活动期血清IIRPCs、MPO、CYP27B1水平比较存在明显差异,其中重度活动期与轻度、中度活动期患者血清IIRPCs、MPO、CYP27B1水平比较,差异均有统计学意义(P<0.05);轻度活动期患者与中度活动期患者比较,差异无统计学意义(P>0.05)。相关性分析显示,IBD患者的血清IIRPCs、MPO、CYP27B1水平与肠道肠球菌、肠杆菌、拟杆菌、酵母菌数量呈正相关,与乳酸杆菌、双歧杆菌数量呈负相关(P<0.05)。结论IBD患病人群肠道菌群分布的变化与血清IIRPCs、MPO、CYP27B1水平的变化存在一定相关性,均与患者疾病活动性有关,二者之间可能共同作用,参与并影响IBD的发生、发展。血清IIRPCs、MPO、CYP27B1可作为无创性生物标志物用于IBD患者与非IBD肠道疾病患者的鉴别诊断及IBD患者疾病活动性的评估。

Distribution characteristics of intestinal flora and its relationship with the levels of IIRPCs,MPO and CYP27B1 in serum of patients with IBD

Objective To investigate the distribution of intestinal flora in patients with inflammatory bowel disease(IBD)and its relationship with the expression of immune inflammatory protein complexes(IIRPCs),myeloperoxidase(MPO)and vitamin D1-αhydroxylase(CYP27B1)in serum.Methods From July 2016 to April 2020,106 IBD patients were selected as the case group,including 58 cases of ulcerative colitis(UC group)and 48 cases of Crohn′s disease(CD group).Sixty patients with non IBD intestinal diseases who received treatment in the hospital during the same period were selected as the disease control group,and 60 healthy people who underwent colonoscopy in the same period were selected as the healthy control group.Serum samples and fresh stool samples were collected from all subjects.The expression levels of serum IIRPCs,MPO,CYP27B1 and fecal bacterial culture were detected respectively.The distribution characteristics of intestinal flora and the expression levels of serum IIRPCs,MPO and CYP27B1 in different groups were compared,and the correlation was analyzed.Results The number of Enterococcus,Enterobacter,Enterococcus,Bacteroides and Yeast in UC group and CD group were significantly higher than those in disease control group and healthy control group,while Lactobacillus,Bifidobacterium and Eubacterium were significantly decreased(P<0.05).In 106 IBD patients,there were also significant differences in the number of intestinal microflora just mentioned between patients in remission stage and active stage,the differences were statistically significant between patients in severe active stage and mild active stage,moderate active stage(P<0.05),but there was no significant difference between patients in mild active stage and moderate active stage(P>0.05).The levels of serum IIRPCs,MPO and CYP27B1 in UC group and CD group were significantly higher than those in disease control group and healthy control group.There were significant differences in the expression levels of IIRPCs,MPO and CYP27B1 between remission stage and active stage,the expression levels of IIRPCs,MPO and CYP27B1 in patients with severe active stage were significantly different from those in mild actine stage and moderate active stage(P<0.05),but there was no significant difference between mild active stage and moderate active stage(P>0.05).Correlation analysis showed that the expression levels of IIRPCs,MPO and CYP27B1 in IBD patients were positively correlated with the number of Enterococcus,Enterobacter,Bacteroides and Yeast,and negatively correlated with the number of Lactobacillus and Bifidobacterium(P<0.05).Conclusion There was a certain correlation between the changes of intestinal flora distribution and the levels of serum IIRPCs,MPO and CYP27B1 in patients with IBD,which were related to the disease activity of patients,the two may play an important role in the occurrence and development of IBD.Serum IIRPCs,MPO and CYP27B1 can be used as noninvasive biomarkers in the differential diagnosis of IBD patients and non IBD patients with intestinal diseases and the evaluation of disease activity in IBD patients.