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

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、Ig...

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

ObjectiveTo explore the effects of intestinal microecological modulators on the intestinal microbiome and immune microenvironment of patients with rheumatoid arthritis (RA).MethodsA 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.ResultsAfter 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).ConclusionIntestinal 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.