肠道菌群失衡与急性胰腺炎易位感染的关系

目的探讨急性胰腺炎患者肠道菌群与胰腺炎易位感染的关系。方法前瞻性地募集重症急性胰腺炎患者171名,根据是否发生易位感染,分为急性胰腺炎非感染组(131名)和急性胰腺炎易位感染组(40名),所有入选者入院时收集粪便标本和血清,分别采用实时荧光定量PCR和分光光度法测定肠道菌群组成及肠道屏障功能,探讨肠道菌群与胰腺炎肠道屏障以及易位感染的关系。结果急性胰腺炎易位感染组患者入院时肠道菌群中的肠杆菌以及肠球菌含量较非感染组显著增加,实时荧光定量PCR结果发现感染组患者潜在致病菌如肠球菌、肠杆菌显著高于非感染组,与肠道黏膜屏障功能的内毒素水平、二胺氧化酶活性以及D-乳酸含量显著正相关,而双歧杆菌显著低于非感染组,与内毒素水平、二胺氧化酶活性以及D-乳酸含量显著负相关,结果提示肠道菌群失衡可能是急性胰腺炎易位感染发生的主要原因之一。结论肠道菌群失衡是急性胰腺炎易位感染发生的高危因素,与急性胰腺炎易位感染发生相关。

Relationship between intestinal flora imbalance and translocation infection in acute pancreatitis

Abstract: Objective To investigate the relationship between intestinal flora and pancreatitis translocation in acute pancreatitis. Methods 171 patients with severe acute pancreatitis were prospectively recruited and divided into non-infection group (131 patients) or infection group (40 patients) according to whether there was translocation infection. The specimens of stool and serum of the participants were collected on admission. Real-time quantitative PCR and spectrophotometry were used to determine the dominant intestinal flora and intestinal barrier function, respectively, and the relationship between intestinal flora and intestinal barrier and translocation of pancreatitis were observed. Results The numbers of Enterobacteria and Enterococci in the infection group was significantly higher than those in the non-infection group, and were positively correlated with the levels of endotoxin and D-lactic acid and the activity of diamine oxidase in the intestinal mucosa. The number of Bifidobacteria was significantly lower in the infection group than in non infection group, and was negatively correlated with the levels of endotoxin and D-lactic acid and the activity of diamine oxidase in the intestinal mucosa. The results suggested that the imbalance of intestinal flora may be one of the important causes of translocation infection of acute pancreatitis. Conclusion Imbalance of intestinal flora is a high risk factor of translocation infection in acute pancreatitis, and is associated with translocation infection in acute pancreatitis.