妊娠期糖尿病患者重要肠道菌群的特征分析及其与炎症因子的相关性研究

发布时间：2018-05-27 00:44

  本文选题：糖尿病 + 妊娠　； 参考：《中国糖尿病杂志》2017年04期

【摘要】：目的观察GDM患者重要肠道菌群的变化特征,分析与炎症因子的相关性。方法选取GDM患者(GDM组)116例、妊娠期NGT女性(GNGT组)101名及非妊娠体检健康女性(NC组)80名。采用稀释平板计数法和快速细菌鉴定法对各组肠杆菌、肠球菌、双歧杆菌、乳杆菌、拟杆菌及梭杆菌进行定性、定量分析。采用ELISA和免疫荧光法测定TNF-α、IL-6、高敏C反应蛋白(hsC-RP)水平。Spearman相关分析肠道菌群与炎症因子的相关性。结果与NC组比较,GNGT组和GDM组BMI、SBP、DBP升高(P0.01)。与GNGT组比较,GDM组SBP、DBP、FPG、HbA_1c、TC、TG、HDL-C均升高(P0.05或P0.01)。与NC组比较,GNGT组和GDM组肠杆菌[(7.14±0.28)vs(8.26±0.90)vs(9.54±1.08)logN/g]和拟杆菌[(7.99±1.46)vs(8.94±1.43)vs(9.45±1.68)logN/g]的菌落数增多,双歧杆菌[(10.47±0.18)vs(8.06±0.32)vs(7.35±0.49)logN/g]和乳杆菌[(7.52±1.36)vs(6.75±1.86)vs(5.31±0.68)logN/g]的菌落数降低(P0.05或P0.01)。GDM组肠杆菌和拟杆菌的菌落数较GNGT组增多,双歧杆菌和乳杆菌的菌落数降低,且肠球菌[(8.30±1.42)vs(6.81±0.57)、(7.12±1.80)logN/g]的菌落数高于NC组和GNGT组(P0.05);GDM组TNF-α[(235.63±28.60)vs(126.77±12.05)、(123.43±14.92)ng/L]、IL-6[(147.73±24.26)vs(77.44±9.55)、(75.61±10.07)ng/L]及hsC-RP[(4.58±017)vs(1.21±0.20)、(1.05±0.19)mg/L]水平高于其他两组(P0.01),而NC组和GNGT组比较,差异无统计学意义(P0.05);Spearman相关分析发现,肠杆菌与TNF-α、IL-6及hsC-RP呈正相关(r=0.535、0.557、0.512,P0.05或P0.01);肠球菌与TNF-α和IL-6呈正相关(r=0.534、0.504,P0.05);双歧杆菌(r=-0.681、-0.517)、乳杆菌(r=-0.425、-0.560)及拟杆菌(r=0.483、-0.432)与TNF-α和IL-6呈负相关(P0.05或P0.01);梭杆菌与TNF-α、IL-6及hsC-RP均无相关性(P0.05)。结论妊娠期女性肠道益生菌减少,致病菌增加,GDM患者表现更为明显,推测肠道菌群可能在GDM的发生发展中发挥一定作用,且该作用可能与炎症因子水平变化有关。
[Abstract]:Objective To observe the change characteristics of important intestinal flora in GDM patients and to analyze the correlation with inflammatory factors. Methods 116 cases of GDM patients (group GDM), 101 pregnant women in pregnancy (group GNGT) and 80 non pregnant healthy women (group NC) were selected. The dilution plate counting method and rapid bacterial identification method were used to treat enterobacteria, Enterococcus, bifidobacteria, milk. ELISA and immunofluorescence were used to determine the correlation between TNF- alpha, IL-6, and high sensitive C reactive protein (hsC-RP) level.Spearman correlation analysis of intestinal flora and inflammatory factors by using ELISA and immunofluorescence. The results were compared with those in the NC group, GNGT and GDM group BMI, SBP, DBP. TC, TG, and HDL-C increased (P0.05 or P0.01). Compared with the NC group, the colony number of Enterobacteriaceae in GNGT group and GDM Group [(7.14 + 0.28) vs (8.26 + 0.90) vs (9.54 + 1.08) logN/g] and (7.99 + 1.46) vs (8.94 + 1.43) (9.45 + 1.68) increased. .86) the colony number of vs (5.31 + 0.68) logN/g] decreased (P0.05 or P0.01), the colony number of Enterobacteriaceae and bacteriobacteria increased more than that of the GNGT group, and the colony number of bifidobacteria and Lactobacillus decreased, and the number of colonies of Enterococcus [(8.30 + 1.42) vs (6.81 + 0.57) and (7.12 + 1.80) logN/g] was higher than that of NC and GNGT group (235.63 + 28.60) (126.77 + 12) .05), (123.43 + 14.92) ng/L], IL-6[(147.73 + 24.26) vs (77.44 + 9.55), (75.61 + 10.07) ng/L] and hsC-RP[(4.58 + 017) vs (1.21 + 0.20), and (1.05 + 0.19) mg/L] level was higher than that of other groups (P0.01), but there was no significant difference between NC and GNGT groups (P0.05). 535,0.557,0.512, P0.05, or P0.01); Enterococcus is positively correlated with TNF- alpha and IL-6 (r=0.534,0.504, P0.05); Bifidobacterium (r=-0.681, -0.517), Lactobacillus (r=-0.425, -0.560) and bacteriobacteria have negative correlation with TNF-. The decrease of probiotic bacteria and the increase of pathogenic bacteria are more obvious in GDM patients. It is presumed that the intestinal flora may play a role in the development of GDM, and this effect may be related to the changes in the level of inflammatory factors.
【作者单位】： 荆州市中心医院妇产科;
【分类号】：R714.256
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本文编号：1939686