手术处理对结直肠癌患者肠道菌群变化的临床研究  

Clinical study on changes of intestinal microflora in patients undergoing colorectal cancer resection

作　　者：郭世奎[1,2] 王昆华[1,2] 包维民[1,2] 龚昆梅[1,2] 

机构地区：[1]云南省第一人民医院普外一科 [2]云南省肠内肠外营养研究中心,云南昆明650032

出　　处：《结直肠肛门外科》2010年第4期201-206,共6页Journal of Colorectal & Anal Surgery

基　　金：云南省应用基础研究基金资助(2005C0074M);(2008ZC085M)

摘　　要：目的探讨结直肠癌手术处理对肠道菌群变化的影响,为临床治疗提供理论依据。方法收集手术前后结直肠癌患者粪便标本50份及正常对照标本50份,应用SYBRGreenI实时荧光定量PCR反应测定不同细菌的。结果正常对照组,手术前、后实验组粪便中细菌数量分别为双歧杆菌(8.85±0.57、5.22±0.45、0.47±0.28)、乳酸杆菌(8.06±0.654.86±0.38、3.52±0.26),手术前、后实验组数量较正常组明显减少(P<0.05),以术后为甚。大肠杆菌为(5.46±0.48、6.57±0.85、4.83±0.47),粪肠球菌为(5.98±0.44、9.76±0.67、2.38±0.14),屎肠球菌为(4.79±0.69、6.88±0.35、1.45±0.19),拟杆菌为(7.98±0.84、9.12±0.53、5.83±0.54),梭杆菌为(8.12±0.78、9.67±0.82、5.41±0.59),梭菌为(5.16±0.55、7.01±0.43、4.42±0.48),术前实验组数量较正常组明显增多(P<0.05),术后实验组数量较术前明显减少(P<0.05)。结论结直肠癌患者手术处理可引起肠道菌群失调,可能与结直肠癌的复发和发展有关,应重视围手术期肠道菌群的微生态调理。Objective To investigate the changes of intestinal flora in preoperative and postoperative patients with colorectal cancer,provide a theoretical basis for clinical treatment. Methods Collected the feces of preoperative and postoperative colorectal cancer patients （n=50） and healthy volunteers （n=50）. Using SYBR Green I real-time fluorescence quantitative PCR to analyze bacterial amounts.Results In preoperative and postoperative group and the level of Bifidobacterium spp. （8.85±0.57,5.22±0.45,0.47±0.28）and Lactobacillus group（8.06±0.65,4.86±0.38,3.52±0.26）in colorectal cancer group were significantly lower than those of healthy controls （P〈0.05）,whereas Escherichia coli （5.46±0.48,6.57±0.85,4.83±0.47）,Enterococcus faecalis （5.98±0.44,9.76±0.67,2.38±0.14） and feces Enterococcus （4.79±0.69,6.88±0.35,1.45±0.19）,Bacteroides （7.98±0.84,9.12±0.53,5.83±0.54）、Fusobacterium （8.12±0.78,9.67±0.82,5.41±0.59） and Clostridium （5.16±0.55,7.01±0.43,4.42±0.48） were significantly higher than those of healthy controls（P〈0.05）,the postoperative experimental group were significantly lower than preoperative experimental group （P〈0.05）.Conclusion Surgery in patients of colorectal cancer impedes the balance of intestinal flora,and may be related to the recurrence and development of colorectal cancer,and microecologic adjustment should be strengthed perioperatively.

关 键 词：结直肠癌 手术 肠道菌群 实时荧光定量PCR 

分 类 号：R735.3[医药卫生—肿瘤]