摘要
目的旨在分析胆囊炎患者经自然腔道内镜手术(NOTES)微创保胆治疗围手术期肠道菌群的变化。方法纳入2018年3月至2018年7月在联勤保障部队第九〇九医院诊断为胆囊炎并拟行经自然腔道内镜手术微创保胆治疗的患者28名,采集围手术期术前和术后相应粪便样本。利用Illumina Miseq测序平台,对细菌的16S rRNA基因V3~V4可变区进行高通量测序,并对测序结果进行生物信息学分析。结果患者围手术期术后与术前采样粪便样本相比,肠道菌群OTU数减少,ace指数和shannon指数降低,差异有统计学意义(P<0.05)。门水平上,拟杆菌门、厚壁菌门丰度明显下降,变形菌门、放线菌门丰度明显增加;属水平上,拟杆菌属、副杆菌属、丹毒丝菌科未培养属等显著减少,其中拟杆菌属丰度减少超过10%;动胶菌属、葡萄球菌属、肠球菌属、链球菌属等显著增加,其中动胶菌属丰度增加超过10%。结论胆囊炎患者行NOTES保胆取石与息肉切除手术,围手术期间患者各种因素影响,肠道菌群丰度和多样性显著下降。
Objective This study aims to investigate the changes of intestinal flora for cholecystitis patients treated with natural orifice transluminal endoscopic surgery(NOTES)for preserving gallbladder.Methods Twenty-eight patients diagnosed with cholecystitis and proposed to undergo minimally invasive biliary preservation treatment with NOTES at the 909 th hospital from March 2018 to July 2018 were included,corresponding preoperative and postoperative stool samples were collected during perioperative period.High-throughput sequencing of V3-V4 variable regions of bacterial 16S rRNA gene was conducted with Illumina Miseq sequencing platform,and sequencing results were analyzed for bioinformatics.Results Compared with the preoperative stool samples,the OTU number,ace index and shannon index decreased with statistically significance for postoperative stool samples(P<0.05).At the level of phylum,bacteroidetes and firmicutes decreased while proteobacteria and actinomyces increased significantly.At the genus level,Bacteroides,Parabacteroides,uncultured genera of Erysipelotrichacea etc.,significantly reduced,among which the abundance of Bacteroides decreased by more than 10%;whereas the genera of Zoogloea,Staphylococcus,Enterococcus and Streptococcus increased significantly,among which the abundance of Zoogloea increased by more than 10%.Conclusion Affected by various factors during perioperative period,patients showed a significant decrease of intestinal flora in the abundance and diversity after bile stone or polyps removal with NOTES.
作者
邓立新
陈艺玲
吕新芝
唐庆林
刘将
温慧萍
温春虹
黄东
王淘淘
张鸣青
DENG Li-xin;CHEN Yi-ling;LV Xin-zhi;TANG Qing-lin;LIU Jiang;WEN Hui-ping;WEN Chun-hong;HUANG Dong;WANG Tao-tao;ZHANG Ming-qing(Department of Gastroenterology,The 909 th Hospital(Dongnan Hospital of Xiamen University),Zhangzhou,Fujian 363000)
出处
《现代消化及介入诊疗》
2022年第4期423-429,共7页
Modern Interventional Diagnosis and Treatment in Gastroenterology
基金
肿瘤生物学国家重点实验室(空军军医大学)开放课题(CBSKL201729)
漳州市科技拥军项目(ZZ2019KD01)
909医院青年苗圃基金(16Y003)。
