Yamamoto-Furusho Jesús K, Torijano-Carrera Emma
Inflammatory Bowel Disease Clinic, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Digestion. 2010;82(1):18-23. doi: 10.1159/000273871. Epub 2010 Feb 9.
Epidemiological and microbiologic studies suggest that enteropathogenic microorganisms play a substantial role in the clinical initiation and relapses of inflammatory bowel disease.
To explore the prevalence of intestinal protozoa in patients with ulcerative colitis (UC) and its impact on clinical disease course.
A total of 215 patients with definitive diagnosis of UC were studied. Fresh feces samples taken from all UC patients were examined immediately using trichrome-staining methods.
A total of 103 female and 112 male UC patients were analyzed. The mean age at diagnosis was 30.5 +/- 10.8 years. The prevalence of overall parasitic infections was 24% and distributed as follows: Blastocystis hominis in 22 patients (10%), Endolimax nana in 19 cases (9%), and Entamoebahistolytica in 11 cases (5%). A significantly increased frequency of protozoa infection was found in those patients with persistent activity and intermittent activity as compared to active than inactive group (p = 1 x 10(-7), OR 13.05, 95% CI 4.28-42.56, and p = 0.003, OR 1.42-14.47, respectively). Interestingly, this association remained significant when we compared the persistent activity group versus intermittent activity group (p = 0.003, OR 2.97, 95% CI 1.35-6.59). Subgroup analysis showed no association between protozoa infection (E. histolytica, B. hominis, and E. nana) and other clinical variables such as gender, extent of disease, extraintestinal complications, medical treatment and grade of disease activity.
The prevalence of intestinal protozoa infections in Mexican UC patients was 24% and these microorganisms could be a contributing cause of persistent activity despite medical treatment in our population.
流行病学和微生物学研究表明，肠道致病微生物在炎症性肠病的临床发病和复发中起重要作用。
探讨溃疡性结肠炎（UC）患者肠道原生动物的患病率及其对临床病程的影响。
共研究了215例确诊为UC的患者。采用三色染色法立即对所有UC患者采集的新鲜粪便样本进行检查。
共分析了103例女性和112例男性UC患者。诊断时的平均年龄为30.5±10.8岁。总体寄生虫感染率为24%，分布如下：人芽囊原虫22例（10%），微小内蜒阿米巴19例（9%），溶组织内阿米巴11例（5%）。与活动期而非非活动期组相比，持续活动组和间歇活动组的原生动物感染频率显著增加（p = 1×10⁻⁷，OR 13.05，95%CI 4.28 - 42.56；p = 0.003，OR 1.42 - 14.47）。有趣的是，当我们比较持续活动组和间歇活动组时，这种关联仍然显著（p = 0.003，OR 2.97，95%CI 1.35 - 6.59）。亚组分析显示原生动物感染（溶组织内阿米巴、人芽囊原虫和微小内蜒阿米巴）与其他临床变量（如性别、疾病范围、肠外并发症、药物治疗和疾病活动度分级）之间无关联。
墨西哥UC患者肠道原生动物感染率为24%，这些微生物可能是导致我国患者尽管接受了药物治疗仍持续活动的一个原因。
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