摘要
目的探讨重症手足口病患儿肠道菌群和肠粘膜通透性的变化,为临床给予益生菌治疗提供参考依据。方法选取西安市儿童医院感染科2013年5月至2015年4月收治的重症手足口病患儿100例作为研究组,同时随机选取同期体检的健康儿童50例作为对照组,采用荧光定量聚合酶链反应(PCR)技术分别检测研究组患儿疾病初期、恢复期及对照组儿童粪便中大肠杆菌及双歧杆菌的含量,同时分别采用改良基质偶氮显色法、改良邻联茴香胺试剂法、酶学分光光度计法检测血液中内毒素、二胺氧化酶(DAO),D-乳酸水平。结果重症手足口病患儿粪便双歧杆菌含量在疾病初期对数值(8.79±0.58CFU/g),显著低于恢复期(9.26±0.98CFU/g)和正常对照组(9.29±0.86CFU/g),F=3.129,P=0.048,恢复期患儿与对照组儿童双歧杆菌含量差异无统计学意义(t=0.088,P=0.930);疾病初期(9.20±0.84CFU/g)和恢复期(9.03±0.82CFU/g)大肠杆菌对数值均显著高于正常对照组(7.58±0.35CFU/g),F=3.707,P=0.028,疾病初期及恢复期大肠杆菌含量相比,差异无统计学意义(t=0.824,P=0.413);双歧杆菌/大肠杆菌的比值(B/E)在疾病初期(0.96±0.24)和恢复期(1.02±0.31)均显著低于对照组儿童(1.23±0.46),F=3.254,P=0.043,疾病初期和恢复期B/E比值差别无统计学意义(t=0.877,P=0.384);重症手足口病患儿血液中内毒素(0.53±0.10EU/mL)、DAO(0.08±0.02μmmol·min^(-1)·mL^(-1))、D-乳酸(5.32±0.97μmmol/mL)与对照组儿童(0.48±0.09EU/mL、0.07±0.01μmmol·min^(-1)·mL^(-1)、4.96±0.90μmmol/mL)比较差异有统计学意义(t值分别为2.468、2.772、2.319,均P<0.05)。结论重症手足口病患儿肠道菌群组成发生变化,大肠杆菌含量增高,疾病初期双歧杆菌含量减少,且伴肠黏膜屏障通透性改变,临床可应用益生菌辅助治疗。
Objective To investigate the changes of intestinal flora and mucosal permeability in severe hand-foot-and-mouth disease （HFMD） cases, and to provide reference for clinical treatment with probiotics. Methods Totally 100 severe HFMD cases were selected in study group from infection department of Xi＇ an Children＇ Hospital from May 2013 to April 2015, and 50 healthy children taking physical examination at the same period were selected in control group. The contents of bifidobacteria and E. coli in stool were detected by Taqman real-time PCR for patient children at early stage and recovery stage and for controls. The levels of Endotoxin, DAO and D-lactate in the serum were detected by improved chromomeric substrate azo, improved method of odianisidine agent and enzymologist spectrophotometers, respectively. Results Bifidobacterialog content at early stage of severe HFMD children （8.79 ± 0.58CFU/g） was significantly lower than that at recovery stage （9.26 ± 0.98CFU/g） and healthy controls （9.29 ±0.86CFU/g） （ F = 3. 129, P = 0. 048）. Cases at recovery stage were not significantly different from controls in bifidobacteria content （ t = 0. 088, P = 0. 930）. The contents of E. coli of cases at early stage （9.20 ±0. 84CFU/g） and recovery stage （9.03±0. 82CFU/g） were significantly higher than control group （7.58 ±0. 35CFU/g） （ F = 3. 707, P = 0. 028）. The contents of E. eoli at early stage was not significantly different from those at recovery stage （ t = 0. 824, P = 0. 413）. Bifidobacteria/E. coli ratio （B/E） at early stage （0.96 ±0. 24） and recovery stage （1.02 ± 0.31 ） were significantly lower than the control group （ 1.23 ±0. 46） （ F = 3. 254, P = 0.043 ）, and there was no significant difference in B/E ratio between early stage and recovery stage （t =0. 877, P =0. 384）. Blood endotoxin （0.53±0.10EU/mL） , DAO （0.08 ±0.02μmmol/min per mL）, D-lactic acid （5.32 ±0.97μmmol/mL） in study group were significantly higher than in the
出处
《中国妇幼健康研究》
2016年第3期323-325,共3页
Chinese Journal of Woman and Child Health Research
关键词
重症手足口病
肠道菌群
肠粘膜屏障
益生菌
severe hand-foot-mouth disease
intestinal flora
intestinal mucosal barrier
probiotics
