肠道微生物与再生障碍性贫血的相关性研究  

The correlation between intestinal microbiota and aplastic anemia

作　　者：陈小玉 吴亮亮[1] 周睿卿[1] 许艳丽[1] 李孔扬 张玉玲 王顺清[1] CHEN Xiaoyu;WU Liangliang;ZHOU Ruiqing;XU Yanli;LI Kongyang;ZHANG YuLing;WANG Shunqing(Department of Hematology,Guangzhou First People＇s Hospital,Guangzhou Medical Uaiversity,Guanzhou 510180,China Corresponding author ： WANG Shunqing E-mail ： [e-mail])

机构地区：[1]广州医科大学附属广州市第一人民医院血液内科,广州510180

出　　处：《实用医学杂志》2018年第16期2744-2749,共6页The Journal of Practical Medicine

摘　　要：目的探讨再生障碍性贫血(AA)患者肠道微生物的变化。方法选取48例AA患者,其中12例为初诊AA患者(初诊组),36例为非初诊AA患者(非初诊组)。收集48例AA患者异基因造血干细胞移植(allo-HSCT)前2周(移植前组)和移植后1个月(移植后组)的粪便样品;同时收集26例供者及10例健康人(对照组)的粪便样品,提取粪便微生物中的16S r RNA并扩增其V4可变区,扩增产物在IlluminaHi Seq 2500平台测序,测序结果进行分析对比。结果初诊组毛螺菌科中位数比对照组降低(6.91%vs.11.27%,P=0.039)。非初诊组毛螺菌科为7.31%,也比对照组降低(P=0.010);但非出诊组毛螺菌科与初诊组相比,差异无统计学意义(P=0.835)。移植前组毛螺菌科为7.20%,也比对照组降低(P=0.005)。移植后组毛螺菌科为9.39%,与移植前组相比,有上升趋势,但差异无统计学意义(P=0.658);移植后组毛螺菌科与对照组相比,差异也无统计学意义(P=0.061)。结论毛螺菌科相对丰度的降低可能与AA相关,抗生素、免疫抑制剂等也许对毛螺菌科的影响较少,allo-HSCT术后AA的免疫紊乱和骨髓衰竭基本被纠正时,毛螺菌科水平整体呈上升趋势。Objective To investigate the correlation between intestinal microbiotaand aplastic anemia （AA）. Methods Forty-eight AA patients, including 12 untreated patients （the untreated group） and 36 treated patients （the treated group ） , were enrolled. Stool specimens were collected in two weeks before allo-HSCT （pre-tranplantgroup） and one month after allo-HSCT （post-tranplant group ）.Stool specimens were also collected in 26 donors and 10 healthy subjects （the control group）.We extracted 16S rRNA from fecal microbiota and amplified its variable region 4 （V4）. The amplicons were sequenced on an Iflumina HiSeq 2500 instrument, and the se- quencing results were analyzed and compared. Results Compared with the control group in which the median rela- tive abundance of Lachnospiraceae was 11.27%, and the median relative abundance of Lachnospiraceae was 6.91% （P = 0.039） and 7.31% （P = 0.010） in the untreated group and the treated group, respectively, with no significant difference （P = 0.835）. The median relative abundance of Lachnospiraceaein the pre-tranplant group was 7.20%, which was lower than that in the control group （P = 0.005 ）. No significant difference was observed in the post- tranplant group in which the relative abundance of Lachnospiraceae was 9.39%, compared with the pre-tranplant （P = 0.658） and the control group （P = 0.061）, respectively. Conclusion The decrease in relative abundance of Lachnospiraceae, which was less influenced by antibiotics and immunosuppressants, may be associated with AA. When the immune disorders and hematopoietic failure were corrected after allo-HSCT, the overall level of Lachno- spiraceaewas shown in an upward trend.

关 键 词：再生障碍性贫血 肠道微生物 毛螺菌科 异基因造血干细胞移植 

分 类 号：R556.5[医药卫生—血液循环系统疾病]