慢性肾衰竭患者肠道菌群改变与肾小球滤过率的关系

探究慢性肾衰竭患者肠道菌群结构改变与肾小球滤过率的关系。

选取2017年3月至2020年3月我院收治的202例慢性肾衰竭患者作为试验组, 并选取198例同期健康体检者作为对照组。收集两组入选者粪便标本并进行检测, 对比两组入选者肠道菌群数量; 同时对比两组入选者体质量、肾小球滤过率、血肌酐、血尿素氮、血胱抑素C水平, 采用Pearson相关性分析肠道菌群改变与肾小球滤过率的相关性。

相比于对照组, 试验组患者肠道双歧杆菌(t=21.915, P < 0.001)、大肠埃希菌数量显著降低(t=18.220, P < 0.001), 肠球菌数量显著增高(t=16.782, P < 0.001)。相比于对照组, 试验组患者肾小球滤过率(t=147.035, P < 0.001)显著降低, 血肌酐(t=43.129, P < 0.001)、血尿素氮(t=170.206, P < 0.001)、血胱抑素C(t=22.432, P < 0.001)水平显著增高。Spearman相关性分析显示, 慢性肾衰竭患者肠道双歧杆菌(r=-0.695, P < 0.001)和大肠埃希菌(r=-0.631, P < 0.001)与肾小球滤过率呈负相关。Logistic回归分析显示, 双歧杆菌、大肠埃希菌、肠球菌、血肌酐、血尿素氮和血胱氨酸均是慢性肾衰竭患者肾小球滤过率降低的独立危险因素。

慢性肾衰竭患者肠道双歧杆菌和大肠埃希菌数量降低、肠球菌数量升高, 且与肾小球滤过率呈显著负相关。

Relationship between intestinal microecological changes and glomerular filtration rate in chronic renal failure

ObjectiveTo explore the relationship between changes in intestinal microecology of chronic renal failure(CRF) and glomerular filtration rate.MethodsTwo hundred and two patients with CRF admitted to our hospital from March 2017 to March 2020 were selected as the observation group, and 198 healthy individuals who had a physical examination during the same period were selected as the control group. Stool specimens from the two groups were collected and tested. Univariate analysis and multivariate analysis were performed on the general data of the two groups, including body weight, glomerular filtration rate, blood creatinine, blood urea nitrogen, and blood cystatin. Pearson correlation was used to analyze the correlation between changes in intestinal microecology and glomerular filtration rate.ResultsCompared with the control group, the counts of intestinal Bifidobacterium(t=21.915, P < 0.001) and E. coli(t=18.220, P < 0.001) in observation group were significantly lower, while that of Enterococcus(t=16.782 P < 0.001) was significantly higher. Compared with the control group, the glomerular filtration rate(t=147.035, P < 0.001) in observation group was significantly lower, but the levels of blood creatinine(t=43.129, P < 0.001), blood urea nitrogen(t=170.206, P < 0.001) and blood cystatin C(t=22.432, P < 0.001) were significantly higher. Spearman analysis showed that intestinal Bifidobacterium(r=-0.695, P < 0.001) and E. coli(r=-0.631, P < 0.001) had negative correlation with glomerular filtration rate. Logistic analysis showed that Bifidobacterium, E. coli, Enterococcus, blood creatinine, blood urea nitrogen and blood cystatin C were the independent risk factors for decreased glomerular filtration rate in patients with CRF.ConclusionThe intestinal Bifidobacteria and E. coli in chronic renal failure patients decreased and intestinal Enterococcus increased, which are negatively correlated with glomerular filtration rate.