摘要
目的探讨反流性食管炎(RE)的严重程度与食管黏膜菌群结构变化的关系。方法选取2017年5-10月于首都医科大学附属北京安贞医院首次就诊的RE患者32例,经胃镜检查确诊为RE,根据RE洛杉矶分型分为轻度RE组(A和B级,21例)和重度RE组(C和D级,11例)。招募17名健康志愿者作为健康对照组。提取受试者食管下段黏膜样本细菌基因组DNA,采用16S r DNA基因扩增和Illumina测序技术将细菌归类。结果轻度RE组、重度RE组与健康对照组之间比较,γ-变形菌纲、普氏菌属、螺杆菌属和莫氏杆菌属丰度差异均有统计学意义[9. 0(8. 5,9. 7)%比9. 9(9. 0,11. 1)%比8. 7(8. 3,9. 2)%、0. 12(0. 06,0. 16)%比0. 13 (0. 09,0. 18)%比0. 20 (0. 14,0. 35)%、0. 04 (0. 02,0. 07)%比0. 02 (0. 02,0. 04)%比0. 10 (0. 03,0. 14)%、0 (0,0)%比0 (0,0)%比0. 002 (0,0. 019)%](P=0. 049、0. 001、0. 034、0. 013)。重度RE组胃食管反流病量表(GERDQ)评分较轻度RE组明显升高[8(8,11)分比4(2,8)分],差异有统计学意义(Z=-2. 876,P=0. 004)。Spearman相关性分析结果显示,RE患者GERDQ评分与厚壁菌门、放线菌门、拟杆菌门、变形菌门均无明显相关性,相关系数分别为0. 213(P=0. 242),-0. 082(P=0. 657),0. 068(P=0. 712),0. 204(P=0. 262)。结论 RE患者食管下段黏膜菌群构成较健康受试者出现明显变化,这可能为RE的防治提供新的方向。
Objective To explore the relationship between severity of reflux esophagitis( RE) and changes of esophageal mucosal microbiome. Methods From May to October 2017,32 RE patients diagnosed by gastroscopy in Beijing Anzhen Hospital,Capital Medical University were divided into mild RE group( Los Angeles typing A and B,21 cases) and severe RE group( Los Angeles typing C and D,11 cases);17 healthy volunteers were recruited as control group. Distal esophageal mucosal genome DNA was extracted and categorized using 16 S r DNA gene amplification and Illumina sequencing technique. Results There were significant differences of γ-Proteobacteria,Prevotella,Helicobacter and Moraxella abundances among mild RE group,severe RE group and control group[9. 0( 8. 5,9. 7)% vs 9. 9( 9. 0,11. 1)% vs 8. 7( 8. 3,9. 2)%,0. 12( 0. 06,0. 16)% vs 0. 13( 0. 09,0. 18)% vs0. 20( 0. 14,0. 35)%,0. 04( 0. 02,0. 07)% vs 0. 02( 0. 02,0. 04)% vs 0. 10( 0. 03,0. 14)%,0( 0,0)% vs0( 0,0)% vs 0. 002( 0,0. 019)%]( P = 0. 049,0. 001,0. 034,0. 013). Gastroesophageal Reflux Disease Questionaire( GERDQ) score in severe RE group was significantly higher than that in mild RE group[8( 8,11) vs4( 2,8)]( Z =-2. 876,P = 0. 004). Spearman analysis showed no correlation of GERDQ score with Firmicutes,Actinobacteria,Bacteroidetes and Proteobacteria;the correlation coefficients were 0. 213( P = 0. 242),-0. 082( P = 0. 657),0. 068( P = 0. 712) and 0. 204( P = 0. 262),respectively. Conclusion The composition of bacterial flora in distal esophageal mucosa of RE patients show obvious changes compared with healthy people,which may provide a new direction for the prevention and treatment of RE.
作者
余英
张杰
高峰
陈雪
孙亚梅
Yu Ying;Zhang Jie;Gao Feng;Chen Xue;Sun Yamei(Department of Gastroenterology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China)
出处
《中国医药》
2019年第10期1519-1523,共5页
China Medicine
基金
首都卫生发展科研专项(首发2018-2-1053)~~
