重症颅脑损伤患者术后肠道菌群变化及其与神经功能缺损程度的相关性  

Changes of intestinal flora in patients with severe craniocerebral injury after surgical operation and its relationships with the degree of neurological impairment

作　　者：赵晓军[1] 乔志刚[1] 梁廷宇 安艳玲 ZHAO Xiao-jun;QIAO Zhi-gang;LIANG Ting-yu;AN Yan-ling(Shanxi Cancer Hospital,Taiyuan,Shanxi 030013,China;不详)

机构地区：[1]山西省肿瘤医院神经外科,山西太原030013 [2]山西卫生健康职业学院内科

出　　处：《中国微生态学杂志》2022年第5期572-575,578,共5页Chinese Journal of Microecology

摘　　要：目的探讨重症颅脑损伤患者术后肠道菌群变化及其与神经功能缺损程度的关系。方法回顾性分析94例在我院进行手术治疗的重症颅脑损伤患者(研究组)的临床资料,另招募82例同年龄段的健康志愿者作为对照组。2组对象均采用PCR扩增+高通量测序法分析肠道菌群,且研究组患者采用美国国立卫生研究院卒中量表(NIHSS)评价术后24 h神经功能缺损程度。对比2组对象肠道菌群结构,同时比较研究组中不同神经功能缺损程度患者的肠道菌群结构,并分析研究组患者肠道微生物PD-whole-three指数、Shannon指数、相对丰度与NIHSS评分的关系。结果研究组患者肠道菌群PD-whole-three指数、Shannon指数以及双歧杆菌属、乳杆菌属、肠球菌属相对丰度均低于对照组,同时重度神经功能缺损患者上述指标水平均低于中度缺损患者,差异均有统计学意义(均P<0.05)。研究组患者肠道梭菌属、拟杆菌属、变形杆菌属、假丝酵母属、葡萄球菌属相对丰度均高于对照组,同时重度神经功能缺损患者上述菌群丰度高于中度缺损患者,差异均有统计学意义(均P<0.05)。Pearson相关性分析表明,研究组患者肠道菌群PD-whole-three指数、Shannon指数以及双歧杆菌属、乳杆菌属、肠球菌属相对丰度均与NIHSS评分呈负相关(均P<0.05),而梭菌属、拟杆菌属、变形杆菌属、假丝酵母属、葡萄球菌属相对丰度均与NIHSS评分呈正相关(均P<0.05)。结论重症颅脑损伤患者术后肠道菌群PD-whole-three指数、Shannon指数和部分菌群丰度变化较大,患者术后肠道菌群与NIHSS评分具有显著相关性。Objective To explore the relationships between intestinal microecological changes and the degree of neurological impairment in patients with severe craniocerebral injury(SCI)after surgical operation.Methods The clinical data of 94 patients with SCI(Observation group)who received surgical treatment in our hospital were retrospectively analyzed,with 82 healthy volunteers of the same age group as the control group.The intestinal microecologies were analyzed by using polymerase chain reaction(PCR)amplification+high-throughput sequencing in both groups,and the degrees of neurological impairment were evaluated with the national institutes of health stroke scale(NIHSS)in observation group at 24 hours after surgery.The structures of intestinal microflora were compared between groups,and among patients with different degrees of neurological impairment,and the relationships between PD-whole-three index,Shannon index,intestinal microbial relative abundance and NIHSS scores in the observation group were analyzed.Results The PD-whole-three index,Shannon index and the relative abundance of Bifidobacteria,Lactobacillus and Enterococcus in the observation group were all lower than those in the control group respectively,and of patients with severe neurological impairment were all lower than those with moderate neurological impairment;the differences were statistically significant(all P<0.05).The relative abundance levels of Clostridium,Bacteroidetes,Proteobacteria,Candida and Staphylococcus in the observation group were higher than those in the control group respectively,and those of the patients with severe neurological impairment were higher than those with moderate neurological impairment;the differences were statistically significant(all P<0.05).Pearson correlation analysis showed that the PD-whole-three index,Shannon index and the relative abundance levels of Bifidobacteria,Lactobacillus and Enterococcus in the observation group were negatively correlated with NIHSS score(all P<0.05),while the relative abundance levels of C

关 键 词：重症颅脑损伤 肠道微生态 神经功能缺损 

分 类 号：R714[医药卫生—妇产科学]