非酒精性脂肪性肝病患者肠道菌群及血清IL-17和INF-γ水平变化*

doi:10.3969/j.issn.1672-5069.2023.06.013

摘要/Abstract

摘要： 目的探讨非酒精性脂肪性肝病(NAFLD)患者肠道菌群及血清白细胞介素17(IL-17)和γ-干扰素(INF-γ)水平变化。方法 2019年1月～2022年1月我院诊治的102例NAFLD患者【单纯性脂肪肝64例和非酒精性脂肪性肝炎(NASH)38例】和同期健康体检者48例,行粪便培养,分离双歧杆菌(B)、乳杆菌、肠杆菌和肠球菌(E),计算B/E比值,采用ELISA 法检测血清IL-17和INF-γ水平。结果 NAFLD患者粪便乳杆菌、双歧杆菌数量和B/E比值分别为(8.9±0.3)lg CFU/g、(8.6±0.3)lg CFU/g和(0.9±0.2),均显著小于健康体检者【分别为(9.9±0.4)lg CFU/g、(9.7±0.4)lg CFU/g和(1.1±0.3),P<0.05】,而肠球菌和肠杆菌数量分别为(8.2±0.3)lg CFU/g和(9.3±0.4)lg CFU/g,均显著大于健康体检者【分别为(7.4±0.2)lg CFU/g和(8.4±0.3)lg CFU/g,P<0.05】;NAFLD患者血清INF-γ水平为(172.6±28.7)ng/L,显著低于健康体检者【(293.7±48.5)ng/L,P<0.05】,而血清IL-17水平为(46.9±8.2)ng/L,显著高于健康体检者【(13.0±2.4)ng/L,P<0.05】;NASH患者粪便乳杆菌、双歧杆菌数量和B/E比值分别为(8.2±0.3)lg CFU/g、(7.9±0.3)lg CFU/g和(0.9±0.2),均显著小于单纯性脂肪肝患者【分别为(9.3±0.4)lg CFU/g、(8.9±0.4)lg CFU/g和(1.1±0.3),P<0.05】,而肠球菌和肠杆菌数量分别为(8.6±0.3)lg CFU/g和(9.5±0.4)lg CFU/g,均显著大于单纯性脂肪肝患者【分别为(7.7±0.2)lg CFU/g和(8.4±0.3)lg CFU/g,P<0.05】;NASH患者血清IL-17水平为(55.4±9.7)ng/L,显著高于单纯性脂肪肝患者【(41.3±7.2)ng/L,P<0.05】,而血清INF-γ水平为(146.9±21.6)ng/L,显著低于单纯性脂肪肝患者【(212.6±36.4)ng/L,P<0.05】。结论 NAFLD患者肠道菌群及血清IL-17和INF-γ水平均发生异常变化,其严重紊乱程度可能提示NASH的发生,个中机制值得进一步探讨。

关键词: 非酒精性脂肪性肝病, 非酒精性脂肪性肝炎, 肠道菌群, 白细胞介素-17, γ-干扰素

Abstract: Objective The purpose of this study was to explore the changes of intestinal flora as well as serum interleukin-17 (IL-17) and interferon-gamma (INF-γ) levels in patients with nonalcoholic fatty liver diseases (NAFLD). Methods 102 patients with NAFLD, including simple fatty liver (SFL) in 64 cases and non-alcoholic steatohepatitis (NASH) in 38 cases, and 48 healthy individuals were encountered in our hospital between January 2019 and January 2022. The intestinal flora and serum IL-17 and INF-γ levels were determined and compared. Results The fecal lactobacilli, bifidobacteria numbers and the bifidobacteria/ enterococcus (B/E) ratio in patients with NAFLD were (8.9±0.3)lg CFU/g,(8.6±0.3)lg CFU/g and (0.9±0.2), all significantly lower than [(9.9±0.4)lg CFU/g, (9.7±0.4)lg CFU/g and (1.1±0.3), respectively, P<0.05], while the fecal enterococcus and enterobacter numbers were (8.2±0.3)lg CFU/g and (9.3±0.4)lg CFU/g, both significantly higher than [(7.4±0.2)lg CFU/g and (8.4±0.3)lg CFU/g, respectively, P<0.05] in healthy persons; serum INF-γ level was (172.6±28.7)ng/L, much lower than [(293.7±48.5)ng/L, P<0.05], while serum IL-17 level was (46.9±8.2)ng/L, much higher than [(13.0±2.4)ng/L, P<0.05] in healthy individuals; the fecal lactobacilli, bifidobacteria numbers and the B/E ratio in patients with NASH were (8.2±0.3)lg CFU/g,(7.9±0.3)lg CFU/g and (0.9±0.2), all significantly lower than [(9.3±0.4)lg CFU/g, (8.9±0.4)lg CFU/g and (1.1±0.3), respectively, P<0.05], while the fecal enterococcus and enterobacter numbers were(8.6±0.3)lg CFU/g and (9.5±0.4)lg CFU/g, both significantly higher than [(7.7±0.2)lg CFU/g and (8.4±0.3)lg CFU/g, respectively, P<0.05] in patients with SFL; serum IL-17 level was (55.4±9.7)ng/L, much higher than [(41.3±7.2)ng/L, P<0.05], while serum INF-γ level was (146.9±21.6)ng/L, much lower than [(212.6±36.4)ng/L, P<0.05] in patients with SFL. Conclusion The intestinal flora, and serum IL-17 and INF-γ levels change abnormally in patients with NAFLD, which might be related to the liver injury, and needs further investigation.

Key words: Nonalcoholic fatty liver diseases, Nonalcoholic steatohepatitis, Intestinal flora, Interleukin-17, Interferon-γ

侯义林, 曹风华, 纪小燕, 蔡燕. 非酒精性脂肪性肝病患者肠道菌群及血清IL-17和INF-γ水平变化^*[J]. 实用肝脏病杂志, 2023, 26(6): 819-822.

Hou Yilin, Cao Fenghua, Ji Xiaoyan, et al. Changes of intestinal flora as well as serum interliukin-17 and interferon-γ levels in patients with nonalcoholic fatty liver diseases[J]. Journal of Practical Hepatology, 2023, 26(6): 819-822.

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非酒精性脂肪性肝病患者肠道菌群及血清IL-17和INF-γ水平变化^*

Changes of intestinal flora as well as serum interliukin-17 and interferon-γ levels in patients with nonalcoholic fatty liver diseases

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