【摘要】 目的分析132例十二指肠球部溃疡患者肠道菌群的改变情况,并探讨其临床意义。方法前瞻性收集132例十二指肠球部溃疡患者,根据幽门螺杆菌(HP)阳性与否分为HP阳性组和HP阴性组,收集每组患者的粪便,实时定量多聚酶链式反应(RT-PCR)检测粪便中细菌DNA,分析肠道菌群与临床病理特征的关系。结果所有患者在年龄、性别、吸烟史、家族史及治疗史中均无显著差异(P>0.05),具有可比性。在男女患者中,乳酸杆菌属(LAG)、普氏杆菌属(PRE)、柔嫩梭菌属(CLS)、拟求梭菌属(CCS)、拟脆弱杆菌(BFG)及肠杆菌科(ENG)的滴度在两组中均未见明显差异(P>0.05);两组LAG、PRE、CCS及BFG的滴度在<80岁患者粪便中未见明显差异(P>0.05),而在CLS和ENG中存在明显差异(P<0.05);在≥80岁患者中两组LAG、PRE、CLS、CCS及BFG的滴度未见明显差异(P>0.05),而ENG的滴度存在显著差异(P<0.05)。在吸烟的十二指肠球部溃疡患者粪便中,LAG、PRE、CLS、CCS、BFG及ENG的滴度中仅在ENG中存在显著差异(P<0.05)。而两组LAG、PRE、CLS、CCS、BFG及ENG的滴度在不吸烟患者粪便中未见明显差异(P>0.05)。治疗前十指肠球部溃疡患者粪便中,HP阳性和阴性组在LAG、CLS及ENG中存在显著差异(P>0.05)。治疗后两组仅在ENG中存在显著差异(P<0.05)。结论十二指肠球部溃疡患者肠道菌群在年龄、吸烟史及家族史中均存在不同程度的改变,临床上应根据患者的具体特征进行合理的治疗,适度调节肠道菌群的平衡,促进溃疡口的愈合。更多还原

【Abstract】 Objective To analyze the change of intestinal microflora in 132 patients with duodenal ulcer(DU) and discuss its clinical significance. Methods 132 patients with DU were prospectively collected and divided into Helicobacter pylori(HP)~+ and HP~- groups according to the presence or absence of HP. The feces of patients were collected and real-time quantitative polymerase chain reaction(RT-PCR) was used for detecting bacterial DNA in feces. Furtherly the relationship between intestinal flora and clinicopathological features was analyzed.Results All patients had no significant differences in age, gender, smoking history, family history and treatment history(P>0.05). They were comparable. In men and women, the titers of LAG, PRE, CLS, CCS, BFG and ENG were not different in either group(P>0.05). In <80 years old patients, the titers of LAG, PRE, CCS and BFG between the two groups were not significantly different(P>0.05), but there were obvious differences in CLS and ENG between the two groups(P<0.05). In ≥80 years old patients, there were no significant differences in titers of LAG, PRE, CLS, CCS and BFG between the two groups(P>0.05), but there was significant difference in titer of ENG(P<0.05). In the feces of DU patients who smoked, there were significant difference in titer of ENG(P<0.05), there were not significant differences in titers of LAG, PRE, CLS, CCS and BFG(P<0.05). The titers of LAG, PRE, CLS, CCS, BFG and ENG between the two groups were not significantly different in the feces of non-smokers(P>0.05). There were significant differences in LAG, CLS and ENG between the HP positive and negative groups in the feces of DU patients before treatment(P<0.05). There was a significant difference between the two groups in the ENG after treatment(P<0.05). Conclusions The intestinal flora of patients with DU has changes in varying age, smoking history and family history. Clinically, reasonable treatment should be performed according to the specific characteristics of the patient and the balance of the intestinal flora should be moderately adjusted to promote ulcer healing.更多还原