【作者】 荀津；

【导师】 夏冰；

【作者基本信息】 武汉大学 ， 临床医学， 2013， 博士

【摘要】 目的：检测湖北省武汉市地区炎症性肠病(Inflammatory bowel disease, IBD)患者艰难梭菌感染率,探讨IBD与艰难梭菌感染(Clostridium difficileinfrtion, CDI)的相关性。方法：纳入2010年9月至2011年12月在武汉大学中南医院确诊的80例IBD患者作为IBD组,包括48例溃疡性结肠炎(Ulcerative colitis,UC)和32例克罗恩病(Crohn’s disease, CD),收集其粪便标本及临床资料,包括IBD诊断、疾病活动性、分型及病变累及部位等。纳入同时期于中南医院行健康体检的46例健康成年人作为对照组1,同期于中南医院就诊的48例一般腹泻患者作为对照组2。采用荧光酶免疫法(Fluorescent enzyme immunoassays, FEIA)检测研究对象粪便中艰难梭菌毒素A&B,分析IBD临床资料与CDI的相关性。结果：IBD组中共检出8例艰难梭菌毒素阳性(10.00%),对照组1及对照组2均未检出阳性。IBD组CDI的发生率显著高于两个对照组(P＜0.05)。处于疾病活动期的IBD患者CDI发生率高于缓解期患者(15.69%vs0,P=0.046)。结肠受累的CD患者CDI发生率显著高于非结肠受累的CD患者(33.33%vs0%,P=0.024)。重度CD患者CDI发生率高于轻度CD患者(P=0.045)。结论：IBD患者艰难梭菌感染率显著高于健康成年人和一般腹泻患者。活动期IBD患者、结肠受累或者病情严重程度为重度的CD患者可能更易感染艰难梭菌。更多还原

【Abstract】 ObjectiveDetect the rate of Clostridium difficile infection in patients of inflammatory bowel disease (IBD) and investigate the relationship between IBD and Clostridium difficile infection (CDI). MethodsEighty IBD patients who were diagnosed in Zhongnan Hospital of Wuhan University from September2010to December2011were admitted as IBD group, including48Ulcerative Colitis (UC) patients and32Crohn’s disease (CD) patients. We collected their stool species and clinical characteristics such as diagnosis, disease activity, classification, anatomic location, treatment and so on. Forty-six healthy adults were admitted as control group1and forty-eight diarrheal patients of other bowel disorders as control group2. We detected C. difficile toxins A&B with fluorescent enzyme immunoassays (FEIA) and analyzed the relationship between clinical characteristics of IBD and CDI. ResultsThere were eight toxin-positive patients in IBD group and none in both control groups.The rate of CDI in IBD group was higher than that in both control groups(P<0.05). The prevalence of CDI was higher in active IBD patients than in remittent IBD patients (15.69%vs0, P=0.046). The incidence of CDI was higher in CD patients of colon involvement than in ones of noncolon involvement (33.33%vsO%, P=0.024). The rate was higher in severe CD patients than in mild ones (P=0.045). ConclusionThe rate of CDI in IBD patients is higher than that in healthy adults and patients of other bowel disorders. IBD patients with active disease and CD patients with colonic involvement or severe condition may be more likely to have CDI.更多还原