强化期抗结核治疗对肺结核患者肠道菌群的影响  

Influence of intensive anti-tuberculosis treatment on intestinal flora

作　　者：潘燕珊 胡锦兴[1] 王维勇[1] PAN Yanshan;HU Jinxing;WANG Weiyong(Guangzhou Chest Hospital,Guangzhou 510095,China)

机构地区：[1]广州市胸科医院,广州510095

出　　处：《广州医药》2022年第1期70-75,80,共7页Guangzhou Medical Journal

基　　金：国家“十三五”科技重大专项课题(2018ZX10715004-002-021);广东省自然科学基金粤科规财字[2018]207号(2018A0303130227);广州市科技计划项目(201904010071)。

摘　　要：目的探讨肠道菌群多样性及丰度在抗结核治疗强化期的变化。方法收集广州市胸科医院20例初治菌阳肺结核患者使用强化方案治疗1周及强化期结束的粪便标本,所有标本进行16S rDNA测序,进行生物信息学分析。结果强化期结束治疗组的Alpha多样性指标Chao1和observed_otus指数分别为(97.8±28.3)和(97.6±28.2),高于治疗1周组的(81±34.7)和(81±34.7),差异有统计学意义(P=0.04;P=0.038)。基于加权和未加权Unifrac距离的PCoA分析显示两组整体菌群结构无明显差异。在相对丰度较高的菌科中,强化期结束治疗组的拟杆菌科、肠球菌科、肠杆菌科、丹毒菌科、卟啉单胞菌科、双歧杆菌科等相对丰度下降,毛螺菌科、梭杆菌科、普氏菌科、瘤胃球菌科、韦氏菌科等相对丰度增加。通过线性判别分析效应量LEfse分析两组数据,发现在属水平上,厚壁菌门的瘤胃球菌、乳杆菌及放线菌门的柯林氏菌为组间显著差异菌种。结论强化期治疗结束与治疗1周相比,肠道菌群多样性增加,但肠道菌群结构无明显差异。肠道拟杆菌科丰度减少,毛螺菌科丰度增加。Objective To investigate the changes in the diversity and abundance of intestinal flora during the intensive period of anti-tuberculosis treatment.Methods Stool specimens from 20 patients with newly treated bacteria-positive pulmonary tuberculosis in Guangzhou Chest Hospital,which were treated with the intensive treatment for 1 week and whole intensive treatment,were collected.All the specimens were subjected to 16S rDNA sequencing and bioinformatics analysis.Results The Alpha diversity index Chao1 and observed_otus index of the treatment group with whole process were(97.8±28.3)and(97.6±28.2)respectively,which were higher than(81±34.7)and(81±34.7)of the 1-week treatment group,which had statistical differences(P=0.04;P=0.038).PCoA analysis based on weighted and unweighted Unifrac distance showed that there was no significant difference in the overall flora community structure between the two groups.Among the bacteria families with higher relative abundance,the relative abundance of Bacteroidaceae,Enterococcaceae,Enterobacteriaceae,Erysipelotrichaceae,Porphyromonadaceae and Bifidobacteriaceae in the treatment group with whole process decreased,the relative abundance content of Lachnodoiraceae,Fusobacteriaceae,Prevotellaceae,Rumincoccaceae,and Veillonellaceae increased.By using linear discriminant analysis effect size(LEfse)to analyze the two sets of data,it was found that at the genus level,Rumincoccaceae of Firmicutes and Lactobacillus;Collinsella of Actinobacteria were significantly different species between the groups.Conclusion Compared with 1 week of treatment,the diversity of intestinal flora increased at the end of intensive treatment,but there was no significant difference in the community structure of intestinal flora.The abundance of intestinal Bacteroidaceae decreased,and the abundance of Lachnodoiraceae increased.

关 键 词：抗结核药物 肠道菌群 16S rDNA 菌群多样性 

分 类 号：R521[医药卫生—内科学]