作　　者： (张炤杰）;

机构地区： 江苏省南京市溧水区人民医院重症医学科,江苏南京211200

出　　处： 《海南医学院学报》 2017年第13期1780-1782,1786,共4页

摘　　要： 目的:探讨多器官功能障碍综合征(MODS)患者肠道菌群紊乱与机体免疫应答、炎症反应的相关性。方法:收集2013年8月~2017年1月间在本院接受治疗的MODS患者60例作为观察组,同期在本院接受体检的健康人50例作为正常对照组,对比两者粪便标本中肠道菌群分布,外周血中T淋巴细胞亚群,血清中免疫球蛋白及炎症因子含量的差异。采用Pearson检验评估MODS患者肠道菌群分布与免疫应答、炎症反应的相关关系。结果:观察组患者粪便组织中双歧杆菌、乳酸杆菌计数及B/E值低于正常对照组(P<0.05),大肠杆菌、肠球菌计数高于正常对照组(P<0.05);外周血中CD4^+T淋巴细胞比例及CD4^+/CD8^+比值低于正常对照组(P<0.05),CD8^+T淋巴细胞比例高于正常对照组(P<0.05);血清中免疫球蛋白IgA、IgM、IgG的含量低于正常对照组(P<0.05);血清中炎症因子降钙素原(PCT)、白介素(IL)-1、IL-6、IL-8、肿瘤坏死因子(TNF)-α的含量高于正常对照组(P<0.05)。经Pearson检验发现,MODS患者肠道菌群紊乱与免疫应答功能、炎症反应程度直接相关。结论:MODS患者存在明显的肠道菌群紊乱,是导致患者免疫功能损伤、全身炎症反应发生的重要原因之一。 Objective：To study the correlation of intestinal flora disturbance with immune response and inflammatory response in patients with MODS.Methods：A total of 60 patients with MODS who were treated in our hospital between August2013 and January 2017 were collected as observation group,and 50 healthy subjects who received physical examination in our hospital during the same period were collected as normal control group.The intestinal flora distribution in the feces samples,peripheral blood contents of T lymphocyte subsets and serum levels of immunoglobulin and inflammatory factors were compared between two groups of subjects.The relationship of intestinal flora distribution with immune response and inflammatory response was assessed by Pearson test.Results：Bifidobacterium and lactobacillus counts as well as B/E value in feces of observation group were lower than those of normal control group while escherichia coli and enterococcus count were higher than those of normal control group;peripheral blood CD4^＋ T lymphocyte proportion and CD4^＋/CD8^＋ ratio were significantly lower than those of normal control group while CD8^＋T lymphocyte proportion was significantly higher than that of normal control group（P〈0.05）;serum immunoglobulin IgA,IgM and IgG levels were significantly lower than those of normal control group（P〈0.05）;serum inflammatory factors PCT,IL-1,IL-6,IL-8and TNF-αlevels were significantly higher than those of normal control group（P〈0.05）.Pearson test showed that the intestinal flora disturbance in patients with MODS is directly correlated with the immune response function and inflammatory response.Conclusions：There is obvious intestinal flora disturbance in patients with MODS,and it is one of the important causes of immune function injury and systemic inflammatory response in patients.

关 键 词： 多器官功能障碍综合征 肠道菌群紊乱 免疫应答 炎症反应