[1]江 娟,李 静,夏 可,等.反复肺炎患儿肠道菌群与免疫功能指标变化及相关性研究[J].陕西医学杂志,2023,52(9):1200-1203.[doi:DOI:10.3969/j.issn.1000-7377.2023.09.019]
　JIANG Juan,LI Jing,XIA Ke,et al.Changes of intestinal flora and immune function indexes in children with recurrent pneumonia and their correlation[J].,2023,52(9):1200-1203.[doi:DOI:10.3969/j.issn.1000-7377.2023.09.019]
点击复制

反复肺炎患儿肠道菌群与免疫功能指标变化及相关性研究
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年9期
页码:
1200-1203
栏目:
临床研究
出版日期:
2023-09-05

文章信息/Info

Title:
Changes of intestinal flora and immune function indexes in children with recurrent pneumonia and their correlation
作者:
江 娟1; 李 静1; 夏 可1; 唐 琴1; 潘 靓1; 刘 梦2
(1.解放军西部战区总医院儿科,四川 成都 610504; 2.四川大学华西第二医院儿科,四川 成都 610044)
Author(s):
JIANG Juan; LI Jing; XIA Ke; TANG Qin; PAN Liang; LIU Meng
(Department of Pediatrics,Western Theater Command General Hospital of PLA,Chengdu 610504,China)
关键词:
肺炎;  儿童;  肠道菌群;  免疫功能;  相关性
Keywords:
Pneumonia;  Child;  Intestinal flora;  Immune function;  Correlation
分类号:
R 725.6
DOI:
DOI:10.3969/j.issn.1000-7377.2023.09.019
文献标志码:
A
摘要:
目的:探讨反复肺炎(RP)患儿肠道菌群与免疫功能指标变化及两者的相关性。方法:选取RP患儿52例为RP组,选取急性肺炎(AP)患儿52例为AP组,选取体检健康儿童52例为对照组。比较三组肠道菌群数量、双歧杆菌和大肠杆菌比值(B/E)、T细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)、免疫球蛋白A(IgA)、IgG以及IgM水平。采用Spearman法分析RP患儿肠道菌群、B/E值与T细胞亚群、IgA、IgG、IgM水平的相关性。结果:RP组双歧杆菌数量、乳杆菌数量和外周血CD3+、CD4+、CD4+/CD8+、IgA、IgG以及IgM水平低于AP组及对照组,且AP组低于对照组(均P<0.05)。RP组大肠杆菌数量和外周血CD8+水平高于AP组及对照组,且AP组高于对照组(均P<0.05)。大肠杆菌数量与CD4+/CD8+、IgA、IgG、IgM水平呈负相关(r=-0.415、-0.421、-0.376、-0.397,均P<0.05)。双歧杆菌数量与CD4+/CD8+、IgA、IgG、IgM水平呈正相关(r=0.441、0.354、0.321、0.426,均P<0.05)。乳杆菌数量与CD4+/CD8+、IgA、IgG、IgM水平呈正相关(r=0.308、0.403、0.421、0.384,均P<0.05)。B/E值与CD4+/CD8+、IgA、IgG、IgM水平呈正相关(r=0.309、0.412、0.374、0.352,均P<0.05)。结论:RP患儿存在肠道菌群紊乱,表现为双歧杆菌、乳杆菌数量降低,大肠杆菌数量升高,同时外周血CD3+、CD4+、CD4+/CD8+、IgA、IgG以及IgM水平降低,且肠道菌群数量与CD4+/CD8+、IgA、IgG、IgM水平有相关性。
Abstract:
Objective:To explore the changes of intestinal flora and immune function indexes in children with recurrent pneumonia(RP)and their correlation.Methods:A total of 52 children with RP were enrolled as RP group,52 children with acute pneumonia(AP)were enrolled as AP group,and 52 healthy children were enrolled as control group.The number of intestinal flora,the ratio of Bifidobacterium to Escherichia coli(B/E),T cell subsets(CD3+,CD4+,CD8+,CD4+/CD8+),immunoglobulin A(IgA),IgG and IgM levels were compared among the three groups.Spearman method was used to analyze the correlation between intestinal flora,B/E value and T cell subsets,IgA,IgG,and IgM levels in RP children.Results:The number of Bifidobacterium and Lactobacillus and the levels of CD3+,CD4+,CD4+/CD8+,IgA,IgG,and IgM in the RP group were lower than those in the AP group and the control group,and those in the AP group were lower than those in the control group(all P<0.05).The number of Escherichia coli and peripheral blood CD8+ level in RP group were higher than those in AP group and control group,and those in AP group were higher than control group(all P<0.05).The number of Escherichia coli was negatively correlated with CD4+/CD8+,IgA,IgG,IgM levels(r=-0.415,-0.421,-0.376,-0.397,all P<0.05).The number of Bifidobacterium was positively correlated with CD4+/CD8+,IgA,IgG and IgM levels(r=0.441,0.354,0.321,0.426,all P<0.05).The number of Lactobacillus was positively correlated with CD4+/CD8+,IgA,IgG,IgM levels(r=0.308,0.403,0.421,0.384,all P<0.05).B/E value was positively correlated with CD4+/CD8+,IgA,IgG,IgM levels(r=0.309,0.412,0.374,0.352,all P<0.05).Conclusion:Children with RP have intestinal flora disorder,which is characterized by a decrease in the number of Bifidobacterium and Lactobacillus,an increase in the number of Escherichia coli,and a decrease in the levels of CD3+,CD4+,CD4+/CD8+,IgA,IgG,and IgM in peripheral blood.The number of intestinal flora is correlated with the levels of CD4+/CD8+,IgA,IgG,and IgM.

参考文献/References:

[1] Bielicki JA,Stöhr W,Barratt S,et al.Effect of amoxicillin dose and treatment duration on the need for antibiotic re-treatment in children with community-acquired pneumonia:The CAP-IT randomized clinical trial[J].JAMA,2021,326(17):1713-1724.
[2] 钟英杰,常 宏,陈 欢,等.C反应蛋白与降钙素原对儿童反复肺炎的诊断价值[J].中国实验诊断学,2020,24(9):1508-1509.
[3] 田大伟,王薛平,吴春青.儿童肺炎反复发作原因前瞻性调查及防控对策研究[J].临床肺科杂志,2018,23(5):872-876.
[4] 王 静,沈红莲,孙建华.肠道菌群失调和免疫失衡与儿童支气管哮喘的关系[J].中国微生态学杂志,2022,34(10):1205-1208.
[5] 胡桂芬,丁光明,刘 俊,等.老年呼吸机相关性肺炎患者肠道菌群特征及其与疾病的相关性[J].中国微生态学杂志,2022,34(7):824-828.
[6] 曾芜薇,余 斓,丁伟艳,等.抗生素诱导的肠道菌群失调加重小鼠肺炎支原体感染[J].中华微生物学和免疫学杂志,2020,40(1):68-73.
[7] 中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.反复呼吸道感染的临床概念和处理原则[J].中华儿科杂志,2008,46(2):108-110.
[8] 倪 鑫.儿童社区获得性肺炎诊疗规范(2019年版)[J].全科医学临床与教育,2019,17(9):771-777.
[9] 赵珍珍,史艳平,邱 锐,等.清热活血方联合阿奇霉素治疗儿童肺炎支原体肺炎临床研究[J].陕西中医,2021,42(5):616-619.
[10] 谢 勇,郭丽丽.支气管哮喘合并肺炎支原体感染患儿糖皮质激素受体α、βmRNA表达检测及其与血清炎症因子、肺功能相关性分析[J].陕西医学杂志,2022,51(9):1142-1145.
[11] 朱燕娜,陈国春,蔡仪术.新生儿合理使用抗生素与其肠道菌群结构和免疫平衡的关系[J].中国妇幼保健,2020,35(20):3818-3821.
[12] García-Trallero O,Herrera-Serrano L,Bibián-Inglés M,et al.Effect of the administration of a probiotic with a combination of lactobacillus and bifidobacterium strains on antibiotic-associated diarrhea[J].Rev Esp Quimioter,2019,32(3):268-272.
[13] 胡尧舜,高广川,李小容,等.肺炎支原体肺炎患儿肠道菌群与血清干扰素-γ和白介素-4水平的关系[J].西部医学,2021,33(11):1687-1690.
[14] 李敬芳,郑文香.复合益生菌制剂对小白鼠生长性能、免疫及抗氧化能力的影响[J].中国饲料,2020,726(11):45-49.
[15] 胡 明,李晓莉,甄 鹏,等.益生菌治疗老年肺炎的临床疗效及其对炎性反应、细胞免疫功能的影响[J].实用心脑肺血管病杂志,2019,27(4):99-102.
[16] Dumas A,Bernard L,Poquet Y,et al.The role of the lung microbiota and the gut-lung axis in respiratory infectious diseases[J].Cell Microbiol,2018,20(12):e12966.
[17] Hufnagl K,Pali-Schöll I,Roth-Walter F,et al.Dysbiosis of the gut and lung microbiome has a role in asthma[J].Semin Immunopathol,2020,42(1):75-93.
[18] Ma Y,Yang X,Chatterjee V,et al.The gut-lung axis in systemic inflammation.Role of mesenteric lymph as a conduit[J].Am J Respir Cell Mol Biol,2021,64(1):19-28.
[19] 王超越,韩 瑨,吴正钧,等.益生菌对宿主肠道屏障功能的影响[J].食品与发酵工业,2022,48(15):309-315.
[20] Liang L,Liu L,Zhou W,et al.Gut microbiota-derived butyrate regulates gut mucus barrier repair by activating the macrophage/WNT/ERK signaling pathway[J].Clin Sci(Lond),2022,136(4):291-307.
[21] Lee Y,Sugihara K,Gillilland MG,et al.Hyaluronic acid-bilirubin nanomedicine for targeted modulation of dysregulated intestinal barrier,microbiome and immune responses in colitis[J].Nat Mater,2020,19(1):118-126.

相似文献/References:

[1]张静,康红刚,王丽萍,等.早期肠内营养对中晚期肺癌合并肺炎患者炎症因子的影响[J].陕西医学杂志,2016,(10):1318.
　Zhang Jing,Kang Honggang,Wang Liping,et al.[J].,2016,(9):1318.
[2]刘萌,曹彬.成年人支原体肺炎合并病毒感染者细胞因子表达研究[J].陕西医学杂志,2016,(10):1375.
　Liu Meng,Cao Bin,[J].,2016,(9):1375.
[3]豆玉凤,史艳平,雷伟,等.喜炎平治疗儿童支原体肺炎40例临床观察[J].陕西医学杂志,2016,(10):1420.
[4]吴华杰,郭武玲,李聪聪,等.孟鲁司特钠联合阿奇霉素治疗肺炎支原体感染120例临床疗效观察[J].陕西医学杂志,2018,(12):1638.
[5]肖小兵,刁诗光,邱建武,等.小儿重症支原体肺炎阿奇霉素干预对疗效及患者免疫功能、肺功能的变化影响及其相互关系*[J].陕西医学杂志,2019,(3):326.
　XIAO Xiaobin,DIAO Shiguang,QIU Jianwu,et al.The effects of azithromycin on treatment of children severe mycoplasma pneumoniaeand immune function and lung function changes and the correlation study[J].,2019,(9):326.
[6]王小飞,刘本寅,张 雅,等.漏斗胸患者手术前后小气道改变评估中多层螺旋CT应用价值研究*[J].陕西医学杂志,2020,49(3):329.
　WANG Xiaofei,LIU Benyin,ZHANG Ya,et al.Clinical value of multi-slice spiral CT in evaluation of small airway changes in patients with pectus excavatum before and after operation[J].,2020,49(9):329.
[7]刘燕飞,李 娟,陈广生,等.儿童非典型性骨外尤文肉瘤4例临床病理分析[J].陕西医学杂志,2020,49(3):360.
　LIU Yanfei,LI Juan,CHEN Guangsheng,et al.Clinicopathologic analysis of 4 cases of atypical extraskeletal Ewing sarcoma in children[J].,2020,49(9):360.
[8]王 洁,王 蓓,朱 晶,等.西北地区1270例儿童变应原检测结果分析*[J].陕西医学杂志,2020,49(6):699.[doi:DOI:10.3969/j.issn.10007377.2020.06.015]
　WANG Jie,WANG Bei,ZHU Jing,et al.Analysis of 1270 cases of children allergens in Northwest China[J].,2020,49(9):699.[doi:DOI:10.3969/j.issn.10007377.2020.06.015]
[9]董欣昌,杨 瑞.利多卡因输注对扁桃体切除术小儿围术期丙泊酚用量及术后不良事件的影响*[J].陕西医学杂志,2020,49(6):741.[doi:DOI:10.3969/j.issn.10007377.2020.06.025]
　DONG Xinchang,YANG Rui..Effect of lidocaine infusion on propofol dosage and postoperative adverse events in perioperative period of children[J].,2020,49(9):741.[doi:DOI:10.3969/j.issn.10007377.2020.06.025]
[10]尹 梅.喘息性支气管炎患儿红细胞分布宽度与其预后相关性研究[J].陕西医学杂志,2020,49(7):841.[doi:DOI:10.3969/j.issn.10007377.2020.07.020]
　YIN Mei..Correlation between red cell distribution width and prognosis in children with asthmatic bronchitis[J].,2020,49(9):841.[doi:DOI:10.3969/j.issn.10007377.2020.07.020]

备注/Memo

备注/Memo:
基金项目:四川省卫生和计划生育委员会科研课题(17PJ407)
更新日期/Last Update: 2023-09-04