A Comparative Study of Fecal Bacteria between Patients with Malignant Obstructive Jaundice and Healthy People
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摘要:
目的 初步探索恶性梗阻性黄疸患者粪菌群变化特征。 方法 以2019年1月至2019年5月入住昆明医科大学第二附属医院的87例恶行梗阻性黄疸患者为病例库,经纳入排除标准筛选,最终选取10例患者为研究对象、10例患者健康亲属作为对照组标本采集对象,记录年龄、性别、BMI;送检粪便测粪便中菌群16srDNA拷贝数。 结果 (1)实验组粪菌群丰度和多样性指数比对照组低,但无统计学意义(P > 0.05);但是将丰度数据以群落Heatmap图呈现,直观差异明显;(2)将两组数据以菌属为单位按比例细分,发现实验组粪菌属组成较对照组发生了根本性的变化(P < 0.05),其中大肠杆菌志贺菌、链球菌、韦荣氏球菌属、肠球菌属、拟杆菌属显著增加,而魏斯式菌属、梭状芽胞杆菌属等菌属大幅下降。 结论 恶性梗阻性黄疸患者患者粪菌群结构与正常对照组的粪便菌群结构之间存在明显差异,优势菌群菌属发生了根本性的改变。 Abstract:Objective To explore the changing characteristics of fecal bacteria in patients with malignant obstructive jaundice. Methods From January 2019 to May 2019, 87 cases with malignant obstructive jaundice were taken as case bank and screened by inclusion and exclusion criteria. After that, 10 patients and 10 healthy relatives of patients were selected, age, sex and BMI were recorded, and faeces were sent for 16srDNA copy number. Results (1)The fecal bacteria abundance and diversity index of the experimental group were lower than that of the control group, but there was no statistical significance (P < 0.05). However, when the data of fecal bacteria abundance were presented in the Heatmap, the intuitive difference was more obvious. (2) The data of the two groups were subdivided by bacteria genus, and it was found that the composition of fecal bacteria genus in the experimental group changed fundamentally compared with that in the control group (P < 0.05). Among them, Escherichia-Shigella, Streptococcus, Veillonella, Enterococcus, Akkermansia increased significantly, while the bacteria genera of wiesia and clostridium declined significantly. Whether the intestinal flora can be rebalanced may affect the therapeutic effect. Conclusion The fecal flora structure of patients with malignant obstructive jaundice is significantly different from that of normal control group, and the dominant flora genus has been fundamentally changed. -
Key words:
- Malignant obstructive jaundice /
- Fecal bacteria /
- Balance
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表 1 患者一般临床资料比较(n/
$\bar x \pm s$ )Table 1. Comparison of patients’ general clinical data (n/
$\bar x \pm s$ )组别 n 性别(n) 年龄(岁) BMI(kg/m2) 男 女 g1 10 6 4 57.00 ± 10.10 25.47 ± 2.60 g2 10 6 4 56.80 ± 7.62 26.38 ± 2.26 t 0.050 −0.843 P P > 0.05 P > 0.05 表 2 两组间总体粪菌群丰度、多样性的比较
Table 2. Comparison of the abundance and diversity of total fecal flora between the two groups
组别 菌群丰度(pan物种)
($ \bar {{x}} \pm s$)菌群多样性(sobs指数)
($ \bar {{x}} \pm s$)g1 373.05 ± 104.01 165.00 ± 41.03 g2 402.01 ± 107.48 195.44 ± 40.54 t −0.597 −1.624 P P > 0.05 P > 0.05 表 3 两组优势菌属对比(
$ \bar x \pm s$ )Table 3. Comparison of dominant bacteria genera between the two groups (
$\bar x \pm s $ )组别 g1优势菌属 g2优势菌属 g1 12.53 ± 5.43 165.00 ± 41.03 g2 2.36 ± 2.07 0.74 ± 1.63 t 4.644 4.94 P P < 0.05 P < 0.05 -
[1] Stelios F Assimakopoulos,Constantine E Vagianos. Bile duct ligation in rats:A reliable model of hepatorenal syndrome?[J]. World Journal of Gastroenterology,2009,15(1):121-123. doi: 10.3748/wjg.15.121 [2] Ogata Yorihiko,Nishi Masaharu,Nakayama Haruyuki,et al. Role of bile in intestinal barrier function and its inhibitory effect on bacterial translocation in obstructive jaundice in rats.[J]. The Journal of Srgical Rsearch,2003,115(1):18-23. [3] Ji-Young Hong,Eisuke F,Sato,et al. Effect of obstructive jaundice and nitric oxide on the profiles of intestinal bacterial flora in wild and iNOS−/− mice[J]. Journal of Clinical Biochemistry and Nutrition,2009,44(2):160-167. doi: 10.3164/jcbn.08-213 [4] 杜淑旭. 实验性黄疸家兔肠道菌群和胆红素代谢的变化及微生态制剂的调节作用[D]. 武汉: 华中科技大学同济医学院硕士学位论文, 2001. [5] 赵增虎,李成云,张建宇,等. 阻塞性黄疸对肠道微生态环境影响的实验研究[J]. 山西医科大学学报,2007,38(1):37-39. doi: 10.3969/j.issn.1007-6611.2007.01.011 [6] Jones C,Badger S A,Regan M,et al. Modulation of gut barrier function in patients with obstructive jaundice using probiotic LP299v[J]. European Journal of Gastroenterology & Hepatology,2013,25(12):1424-1430. [7] Niu S,Cheng L,Qiao Y,et al. Combined stent insertion and high-intensity focused ultrasound ablation for patients with malignant obstructive jaundice[J]. Surgical Laparoscopy,Endoscopy & Percutaneous Techniques,2016,26(6):488-492. [8] 惠小娜,胡培,张晨宁,等. 肠道菌群对人参皂苷防治肺癌活性影响的研究进展[J]. 中药药理与临床,2017,33(1):218-223. [9] 蒋建文,任志刚,郑树森,等. 肠道微生态与肝癌关系研究新进展[J]. 传染病信息,2016,29(5):264-266. [10] 张黎. 早期应用微生态制剂辅助治疗新生儿黄疸的临床疗效及对免疫功能的影响[J]. 药物与人,2014,27(323):145-145. [11] Sohini Mukherjee,Lora V. Hooper. Antimicrobial defense of the intestine[J]. Immunity,2015,42(1):28-39. doi: 10.1016/j.immuni.2014.12.028 [12] Fukui Hiroshi. Increased intestinal permeability and decreased barrier function:Does it really influence the risk of inflammation?[J]. Inflammatory Intestinal Diseases,2016,1(3):135-145. doi: 10.1159/000447252 [13] 杨清慧,李文涛. 恶性OJ患者胆道分离细菌药敏与感染的相关因素分析[J]. 复旦学报医学版,2017,44(4):489-492. [14] Ahmet Rahmi Hatipoğlu,Serhat Oğuz,Saban Gürcan,et al. Combined effects of tauroursodeoxycholic acid and glutamine on bacterial translocation in obstructive jaundiced rats[J]. Balkan Journal of Medical Genetics,2013,30(4):362-368. doi: 10.5152/balkanmedj.2013.7785 [15] Ridlon J M,Alves J M,Hylemon P B,et al. Cirrhosis,bile acids and gut microbiota:Unraveling a complex relationship.[J]. Gut Microbes,2013,4(5):382-387. doi: 10.4161/gmic.25723 [16] Ridlon J M,Kang D J,Hylemon P B,et al. Bile acids and the gut microbiome[J]. Current Opinion in Gastroenterology,2014,30(3):332-338. doi: 10.1097/MOG.0000000000000057 [17] 廖志勤,杨少芬,林宁,等. 微生态制剂联合非营养性吸吮对早产儿黄疸的干预作用[J]. 广东医学院学报,2009,27(3):258-260. [18] 孙秀凤,单若冰. 梗阻性黄疸与细菌/内毒素移位的关系及微生态制剂干预[J]. 中国微生态学杂志,2008,20(1):95-96. doi: 10.3969/j.issn.1005-376X.2008.01.043 [19] 杨方亮,江勇,姚捷,等. 富含中链脂肪酸和蛋白的肠内营养对恶性梗阻性黄疸手术病人肠屏障功能的影响[J]. 肠外与肠内营养,2017,24(6):351-354. [20] 杨春佳,苏德望,王跃生,等. 金银花对梗阻性黄疸大鼠菌群失调及内毒素血症的调整作用[J]. 中国微生态学杂志,2012,24(8):703-706. [21] Funda Tuzun,Abdullah Kumral,Nuray Duman,et al. Breast milk jaundice:Effect of bacteria present in breast milk and infant feces[J]. Journal of Pediatric Gastroenterology and Nutrition,2013,56(3):328-332. doi: 10.1097/MPG.0b013e31827a964b [22] Mehmet Faruk Geyik,Mustafa Aldemir,Salih Hosoglu,et al. The effects of saccharomyces boulardii on bacterial translocation in rats with obstructive jaundice[J]. The Royal College of Surgeons of England,2015,88(2):176-180.