本文選題：糖尿病 + 妊娠�。� 參考：《中國糖尿病雜志》2017年04期

【摘要】：目的觀察GDM患者重要腸道菌群的變化特征,分析與炎癥因子的相關(guān)性。方法選取GDM患者(GDM組)116例、妊娠期NGT女性(GNGT組)101名及非妊娠體檢健康女性(NC組)80名。采用稀釋平板計數(shù)法和快速細(xì)菌鑒定法對各組腸桿菌、腸球菌、雙歧桿菌、乳桿菌、擬桿菌及梭桿菌進行定性、定量分析。采用ELISA和免疫熒光法測定TNF-α、IL-6、高敏C反應(yīng)蛋白(hsC-RP)水平。Spearman相關(guān)分析腸道菌群與炎癥因子的相關(guān)性。結(jié)果與NC組比較,GNGT組和GDM組BMI、SBP、DBP升高(P0.01)。與GNGT組比較,GDM組SBP、DBP、FPG、HbA_1c、TC、TG、HDL-C均升高(P0.05或P0.01)。與NC組比較,GNGT組和GDM組腸桿菌[(7.14±0.28)vs(8.26±0.90)vs(9.54±1.08)logN/g]和擬桿菌[(7.99±1.46)vs(8.94±1.43)vs(9.45±1.68)logN/g]的菌落數(shù)增多,雙歧桿菌[(10.47±0.18)vs(8.06±0.32)vs(7.35±0.49)logN/g]和乳桿菌[(7.52±1.36)vs(6.75±1.86)vs(5.31±0.68)logN/g]的菌落數(shù)降低(P0.05或P0.01)。GDM組腸桿菌和擬桿菌的菌落數(shù)較GNGT組增多,雙歧桿菌和乳桿菌的菌落數(shù)降低,且腸球菌[(8.30±1.42)vs(6.81±0.57)、(7.12±1.80)logN/g]的菌落數(shù)高于NC組和GNGT組(P0.05);GDM組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]水平高于其他兩組(P0.01),而NC組和GNGT組比較,差異無統(tǒng)計學(xué)意義(P0.05);Spearman相關(guān)分析發(fā)現(xiàn),腸桿菌與TNF-α、IL-6及hsC-RP呈正相關(guān)(r=0.535、0.557、0.512,P0.05或P0.01);腸球菌與TNF-α和IL-6呈正相關(guān)(r=0.534、0.504,P0.05);雙歧桿菌(r=-0.681、-0.517)、乳桿菌(r=-0.425、-0.560)及擬桿菌(r=0.483、-0.432)與TNF-α和IL-6呈負(fù)相關(guān)(P0.05或P0.01);梭桿菌與TNF-α、IL-6及hsC-RP均無相關(guān)性(P0.05)。結(jié)論妊娠期女性腸道益生菌減少,致病菌增加,GDM患者表現(xiàn)更為明顯,推測腸道菌群可能在GDM的發(fā)生發(fā)展中發(fā)揮一定作用,且該作用可能與炎癥因子水平變化有關(guān)。
[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.
【作者單位】： 荊州市中心醫(yī)院婦產(chǎn)科;
【分類號】：R714.256
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本文編號：1939686