胃癌术后病人肠道菌群变化及其对围手术期恢复的影响  

Changes of intestinal flora in patients with gastric cancer and its effect on perioperative recovery

作　　者：田华开 郑辞华 刘韦东 许添 温华斌 邓小荣[1] Tian Huakai;Zheng Cihua;Liu Weidong;Xu Tian;Wen Huabin;Deng Xiaorong(Department of General Surgery of the Second Affiliated Hospital of Nanchang University,Jiangxi Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院胃肠外科,江西南昌330006

出　　处：《腹部外科》2020年第1期53-57,共5页Journal of Abdominal Surgery

摘　　要：目的探讨胃癌术后病人肠道菌群的变化及其对病人术后围手术期恢复的影响。方法选择2018年6月至2019年6月南昌大学第二附属医院胃肠外科收治的行胃癌根治术的100例病人,对每位病人术前与术后的粪便进行菌群检测(双歧杆菌、嗜酸乳杆菌、大肠杆菌、链球菌),并根据病人术后有益菌相对丰度分为丰度高组和丰度低组,同时检测病人术后生化指标(白细胞计数、中性粒细胞百分比、C反应蛋白、淋巴细胞计数、淋巴细胞百分比、总蛋白、白蛋白和前白蛋白)。结果通过高通量测序检测胃癌病人手术前后菌群变化,发现胃癌术后病人双歧杆菌、嗜酸乳杆菌明显减少,大肠杆菌、链球菌明显增多,差异有统计学意义(P<0.05)。100例病人中双歧杆菌和嗜酸乳杆菌相对丰富的病人肠道功能恢复较早,炎症指标相对较低,免疫指数有所提高,同时提高总蛋白及白蛋白营养指标,差异有统计学意义(P<0.05)。结论胃癌术后病人肠道菌群发生改变,体内有益菌双歧杆菌、嗜乳酸杆菌减少,大肠杆菌、链球菌明显增加。同时体内有益菌减少会影响病人术后恢复,增加病人炎症反应,降低机体免疫能力,影响病人营养状态。Objective To investigate the changes of intestinal flora in patients with gastric cancer after surgery and its effect on patients'perioperative recovery.Methods A total of 100 patients undergoing radical gastrectomy for gastric cancer who were admitted to the Department of Gastrointestinal Surgery of the Second Affiliated Hospital of Nanchang University from June 2018 to June 2019 were selected.The bacteria(bifidobacteria,lactobacillus acidophilus,escherichia coli,streptococcus)in the feces of each patient before and after surgery were detected.The patients were divided into high abundance group and low abundance group according to the relative abundance of beneficial bacteria after operation.The postoperative biochemical indicators(white blood cell count,neutrophil percentage,CRP,lymphocyte count,lymphocyte percentage,total protein,albumin and prealbumin)were also measured.Results Through high-throughput detection of changes in the flora of gastric cancer patients before and after surgery,we found that patients with gastric cancer after surgery had significantly reduced.Bifidobacterium and Lactobacillus acidophilus,and E.coli and Streptococcus significantly increased,and the difference was statistically significant(P<0.05).Among 100 patients,patients with relatively rich Bifidobacterium and Lactobacillus acidophilus recovered earlier intestinal function,had relatively lower inflammation indexes,improved immune index,and improved total protein and albumin nutrition indexes.The difference was statistically significant(P<0.05).Conclusion The intestinal flora of patients with gastric cancer changed,and the beneficial bacteria Bifidobacterium and Lactobacillus in vivo decreased,and E.coli and Streptococcus increased significantly.At the same time,the reduction of beneficial bacteria in the body will affect the patient's postoperative recovery,increase the patient's inflammatory response,reduce the body's immune capacity,and affect the patient's nutritional status.

关 键 词：胃癌 肠道菌群 术后恢复 

分 类 号：R735.2[医药卫生—肿瘤]