河北医科大学学报 ›› 2023, Vol. 44 ›› Issue (1): 25-29,61.doi: 10.3969/j.issn.1007-3205.2023.01.006

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肠道微生态调节剂影响类风湿关节炎患者肠道微生物组和免疫微环境的临床研究

  

  1. 湖北省十堰市太和医院，湖北医药学院附属医院针灸科，湖北 十堰 442000

  • 出版日期:2023-01-25 发布日期:2023-01-17
  • 作者简介:王婵（1985-），女，湖北十堰人，湖北省十堰市太和医院（湖北医药学院附属医院）主管技师，医学学士，从事慢性病康复研究。
  • 基金资助:
    湖北省卫生健康委科研项目（WJ2021F032）；十堰市引导性科研项目（21Y37）

Clinical study of the effect of intestinal microecological modulators on intestinal microbiome and immune microenvironment in patients with rheumatoid arthritis

  1. Department of Acupuncture and Moxibustion， Taihe Hospital of Shiyan City, the Affiliated Hospital of Hubei Medical College， Hubei Province, Shiyan 442000， China

  • Online:2023-01-25 Published:2023-01-17

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摘要： 目的  探究肠道微生态调节剂对类风湿关节炎（rheumatoid arthritis，RA）患者肠道微生物组和免疫微环境的影响。
方法  选择在我院就诊的RA患者90例分为2组：对照组（口服甲氨蝶呤片治疗，n=45）和观察组（肠道微生态调节剂治疗，n=45）。分析肠道微生物组多样性。通过酶联免疫吸附试验检测免疫球蛋白G（immunoglobulin G，IgG）、免疫球蛋白A（immunoglobulin A，IgA）和免疫球蛋白M（immunoglobulin M，IgM）水平。统计2组患者治疗前后病残分级。通过28个关节疾病活动评分-红细胞沉降率（disease activity score 28-erythrocyte sedimentation rate,DAS28-ESR）和28个关节疾病活动度（disease activity score 28,DAS28）评估其对总体健康状况的影响。
结果  治疗后，2组患者微生物组菌群均匀度和微生物组菌群丰富度较治疗前升高，观察组微生物组菌群均匀度和微生物组菌群丰富度较对照组升高，2组患者IgA、IgM和IgG较治疗前升高，观察组IgA、IgM和IgG较对照组升高，2组患者Ⅰ级和Ⅱ级患者比例较治疗前升高，Ⅲ级和Ⅳ级患者比例较治疗前降低（P＜0.05）。治疗后，观察组显效率和总有效率较对照组升高，观察组无效率较对照组降低，观察组患者的疾病活动度评分较对照组升高（P＜0.05）。
结论  肠道微生态调节剂通过调节RA患者肠道微生物组和免疫微环境，能够有效控制RA患者疾病活动的发生发展，是一种安全有效的治疗方法。


关键词: 类风湿关节炎, 肠道微生物组, 免疫微环境

Abstract: Objective  To explore the effects of intestinal microecological modulators on the intestinal microbiome and immune microenvironment of patients with rheumatoid arthritis (RA). 
Methods  A total of 90 RA patients who were treated in our hospital were divided into 2 groups: control group (treated with oral methotrexate tablets, n=45) and observation group (treated with intestinal microecological modulators, n=45). The diversity of the intestinal microbiome was analyzed. The levels of immunoglobulin G (IgG), immunoglobulin A (IgA) and immunoglobulin M (IgM) were detected by enzyme-linked immunosorbent assay (ELISA). The classification of diseases and disabilities in two groups was calculated before and after treatment. Disease activity score 28-erythrocyte sedimentation rate (DAS28-ESR) and disease activity score 28 (DAS28) were used to assess overall health status. 
Results  After treatment, the evenness and richness of microbiome in two groups were increased compared with those before treatment, which were higher in the observation group than in the control group, IgA, IgM and IgG in two groups were increased compared with those before treatment, which were higher in the observation group than in the control group. The proportion of grade Ⅰ and Ⅱ patients in both groups was higher than that before treatment, and the proportion of grade Ⅲ and Ⅳ patients was lower than that before treatment (P＜0.05). After treatment, the significant efficiency and total effective rate in the observation group were higher than those in the control group, while the inefficiency in the observation group was lower than that in the control group; the disease activity score in the observation group was higher than that in the control group (P＜0.05). 
Conclusion  Intestinal microecological modulators can effectively control the occurrence and development of disease activities in RA patients by regulating the intestinal microbiome and immune microenvironment, which is a safe and effective treatment method.


Key words: rheumatoid arthritis, intestinal microbiome, immune microenvironment

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