反复肺炎患儿的肠道菌群与血清D-乳酸变化及相关性研究

Changes in gut microbiota and serum D-lactate level and correlation analysis in children with recurrent pneumonia

摘要:

目的 研究反复肺炎患儿的肠道菌群变化和D-乳酸变化及意义。方法 收集30例反复肺炎(反复组)患儿、30例急性肺炎(急性组)患儿及15例外科手术儿童(外科组)的粪便标本和血标本,采用16S rRNA荧光定量PCR技术定量检测各组粪便标本的双歧杆菌和大肠杆菌的数量,并计算双歧杆菌和大肠杆菌数量对数值的比值(B/E值),同时测定血清D-乳酸含量,并进行肠道菌群与D-乳酸的相关性分析。结果 反复组患儿的双歧杆菌数量以及B/E值均低于急性组及外科组(P<0.05),而大肠杆菌数量高于外科组(P<0.05),反复组患儿的大肠杆菌数量与急性组差异无统计学意义(P>0.05);反复组患儿D-乳酸较急性组及外科组均增高(P<0.05);反复组患儿的B/E值与血清D-乳酸呈直线负相关(r=-0.539,P<0.05)。结论 反复肺炎患儿存在肠黏膜生物屏障及肠黏膜机械屏障受损。

Abstract:

Objective To study the changes in gut microbiota and serum D-lactate level and their significance in children with recurrent pneumonia.Methods The stool and blood samples were collected from 30 children with recurrent pneumonia(recurrent group), 30 children with acute pneumonia(acute group), and 15 children receiving surgical operation(surgery group).The 16S rRNA fluorescent quantitative polymerase chain reaction(FQ-PCR) was applied to determine the numbers of Bifidobacterium and Escherichia coli in stool samples, and the ratio between the logarithmic values of the numbers of Bifidobacterium and Escherichia coli(B/E value) was calculated.The serum D-lactate level was measured, and correlation analysis was performed.Results The recurrent group had a significantly lower number of Bifidobacterium and a significantly lower B/E value than the acute group and the surgery group(P<0.05), as well as a significantly higher number of Escherichia coli than the surgery group(P<0.05).There was no significant difference in the number of Escherichia coli between the recurrent group and the acute group.The recurrent group had a significantly higher serum D-lactate level than the acute group and the surgery group(P<0.05).In the recurrent group, B/E value was negatively correlated with serum D-lactate level(r=-0.539, P<0.05).Conclusions Children with recurrent pneumonia may have biological and mechanical barrier damage in the intestinal mucosa.