肝硬化患者肠道微生态的变化  

Changes in intestinal microflora in patients with hepatic cirrhosis

作　　者：吴旭[1,2] 吴云峰[1] 毛朝亮[1] 吴中明[2] 

机构地区：[1]遵义市第一人民医院消化内科,贵州省遵义市563000 [2]遵义医学院基础医学院微生物学研究室,贵州省遵义市563000

出　　处：《世界华人消化杂志》2012年第26期2491-2495,共5页World Chinese Journal of Digestology

摘　　要：目的:观察肝硬化(hepatic cirrhosis,HC)患者粪便中类杆菌、双歧杆菌、肠球菌、大肠杆菌、直肠真杆菌-球形梭菌和梭状芽胞杆菌,比较肝硬化患者与健康对照组之间肠道微生态的差异,以了解肝硬化患者肠道菌群的变化.方法:收集2010-03/2010-12遵义市第一人民医院消化科所收治的肝硬化患者29例,并以13例同期健康在校大学生作对照,收集粪便标本.经固定、玻片上涂片,荧光原位杂交(fluorescent in situ hybridization,FISH),激光共聚焦扫描显微镜(laser scanning confocal microscopy,LSCM)对细菌进行计数观察.应用秩相关检测法进行分析.结果:肝硬化患者与健康对照组比较粪便中双歧杆菌、类杆菌、真杆菌-直肠梭菌、肠球菌、大肠杆菌和梭状芽胞杆菌均较健康对照组显著减少(Z=-4.006、-4.34、-4.399、-4.174、-3.558、-3.95,均P<0.01),6种细菌的比例发生改变,表现为双歧杆菌及类杆菌专性厌氧菌的数量减少,大肠杆菌、直肠真杆菌-球形梭菌、肠球菌和芽胞杆菌的数量增多(P<0.05).细菌数量及比例之间的这种改变与肝硬化病因及肝硬化严重程度(Child-Pugh)分级无明显相关性(P>0.05).结论:肝硬化患者肠道中6种细菌数量及构成比发生改变,肠道微生态的这种变化与肝硬化不同病因及疾病严重程度之间无明显相关性.AIM：To compare the differences in the numbers of Bifidobacterium, Bacteroides, Eubacterium rectale-Clostridium, Escherichia coli, Enterococcus, Clostridium difficile in stool samples between patients with hepatic cirrhosis and controls to understand the changes in intestinal flora in patients with hepatic cirrhosis. METHODS：Stool samples collected from 29 patients with hepatic cirrhosis who were treated at the First People’s Hospital of Zunyi during the period between March to December 2010 and 13 healthy volunteers were used in this study. The samples were fixed, smeared on slides, and analyzed by fluorescent in situ hybridization （FISH） and laser scanning confocal microscopy （LSCM）. The t-test and rank correlation test were used for statistical analysis. RESULTS：The numbers of Bifidobacterium, Bacteroides, Eubacterium rectale-Clostridium, Escherichia coli, Enterococcus, and Clostridium difficile were significantly lower in patients with hepatic cirrhosis than in controls （Z = -4.006, -4.34, -4.399, -4.174, -3.558, -3.95; all P〈0.01）. The proportions of all 6 kinds of bacteria were changed. The numbers of obligate anaerobes such as Bifidobacteria and Bacteroides were reduced, while those of E. coli, Eubacterium rectale-Clostridium, Enterococcus, and ClostriDium difficile were increased （all P〈0.05）. The numbers and portions of bacteria had no significant correlation with etiology and severity of hepatic cirrhosis （Child-Pugh classification）. CONCLUSION：The numbers and proportions of six kinds of bacteria changed in patients with hepatic cirrhosis. Changes in intestinal microflora have no significant correlation with etiology and Child-Pugh classification.

关 键 词：肝硬化 肠道微生态 荧光原位杂交 激光共聚焦扫描显微镜 

分 类 号：R575.2[医药卫生—消化系统]