益生菌酪酸梭菌胶囊在直肠癌患者围手术期的保护作用研究  

Protective effect of probiotics Clostridium butyricum capsules in perioperative period of rectal cancer patients

作　　者：史新龙[1] 陈小婕[2] 李晶晶 朱成章 王赫 张维胜[1] 杨熊飞[1] SHI Xin-long;CHEN Xia-jie;LI Jing-jing;ZHU Cheng-zhang;WANG HE;ZHANG WEI-sheng;ANG Xiong-fei(Deparment of Anorectal Surgery,the GanSu prowincial IAL hospitalan Zhou 730000,China;Deparment of Scientific Research,theGanSu proineial Al.hosptal,lanZhou 7300,China;Deparment of graduate school,the Ningxia Medical University,YinChuan750004,China;Deparment of Graduate School,the Gansu University 0f Chinese Medicine,LanZhou 730000,China)

机构地区：[1]甘肃省人民医院肛肠科,730000 [2]甘肃省人民医院科研处,730000 [3]宁夏医科大学研究生学院,750004 [4]甘肃中医药大学研究生学院,730000

出　　处：《现代消化及介入诊疗》2020年第10期1306-1310,共5页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：甘肃省青年科技基金(17JR5RA031);甘肃省人民医院院内科研基金(17GSSY7-6);兰州市科技发展指导性计划(2019-ZD-103)。

摘　　要：目的探讨益生菌酪酸梭菌胶囊对结直肠癌患者手术前后肠道菌群多样性、相对丰度及肠黏膜屏障功能的影响。方法选取拟行直肠癌手术患者60例,采用自身对照,采集干预前血液、粪便、肠镜活检标本。术前3 d给予酪酸梭菌胶囊口服1260 mg/次,2次/d,连用3 d。行腹腔镜下直肠癌根治性切除术后,当日采集患者病理标本,术后第一天采集患者血液标本,待患者通气排便后,采集新鲜粪便标本。采集粪便标本提取DNA并进行16S rRNA测序比较围手术期肠道菌群多样性变化,应用免疫组化、ELISA探究肠黏膜屏障功能指标(MUC2、NO、SlgA)的变化。结果酪酸梭菌胶囊干预前,45%的患者出现肠道菌群失调。干预后革兰氏阳性球菌及阴性杆菌比例下降,革兰氏阴性球菌及阳性杆菌比例上升。酪酸梭菌胶囊干预前后,肠道菌群多样性无明显变化。干预后,组织中MUC2和SIgA表达水平明显增加,而NO表达下调。结论术前酪酸梭菌胶囊干预可降低结肠直肠癌患者黏膜通透性,保护和修复肠黏膜屏障功能,减少肠道菌群易位。Objective To investigate the effects of Clostridium butyricum capsules on intestinal microbial diversity,relative abundance and intestinal mucosal barrier function in colorectal cancer patients before and after operation.Methods Sixty patients posted for surgery in rectal cancer were enrolled in this study.Clinical samples such as blood,feces and colonoscopy biopsy specimens were collected before surgical intervention.Clostridium butyricum capsule 1260 mg twice daily was given orally for three days prior to surgery.After the resection of rectal cancer through laparoscopic radical,the pathological specimens of the patients were collected.Blood samples were collected on the first day after operation,and fresh fecal samples were collected after ventilation and defecation.The genomic DNA was extracted from the fecal samples for 16 S rRNA sequencing to compare the changes of intestinal flora diversity during perioperative period.Changes of intestinal mucosal barrier function character,like MUC2,NO,and SlgA,were detected through immunohistochemistry and ELISA.Results Before the intervention of Clostridium butyricum capsule,45%of patients had intestinal flora imbalance.After the intervention,the proportion of Gram-negative bacteria increased.There was no significant change in intestinal flora diversity before and after the intervention of Clostridium butyricum capsule.After the intervention,the expression of MUC2 and SIgA increased significantly,while the expression of NO decreased.Conclusion The intervention of Clostridium butyricum capsule before operation can reduce the mucosal permeability of patients with rectal cancer,protect and repair the intestinal mucosal barrier function,and reduce the translocation of intestinal microbiome.

关 键 词：直肠癌 益生菌 酪酸梭菌 黏膜屏障 相对丰度 微生物多样性 

分 类 号：R452[医药卫生—治疗学] R574[医药卫生—临床医学]