脑胶质瘤术后肺部感染患者肠道微生态平衡及肠道屏障功能变化  

Changes of intestinal microecological balance and intestinal barrier function of glioma patients with postoperative pulmonary infection

作　　者：杨丽[1] 王育文[1] 苏芳[1] 杨燕[1] 蒋苏雪 YANG Li;WANG Yu-wen;SU Fang;YANG Yan;JIANG Su-xue(the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215000,China)

机构地区：[1]苏州大学附属第一医院神经外科,江苏苏州215000

出　　处：《中华医院感染学杂志》2022年第9期1319-1322,共4页Chinese Journal of Nosocomiology

基　　金：苏州市民生科技-关键技术应用研究资助项目(SS201864)。

摘　　要：目的 探究肠道微生态平衡及屏障功能与脑胶质瘤术后肺部感染的关系。方法 选取2018年1月-2020年12月苏州大学附属第一医院神经外科收治的60例脑胶质瘤术后肺部感染患者为感染组,另选取同期60例脑胶质瘤术后无感染患者为非感染组,比较两组患者肠道菌群状况,肠道屏障功能指标[二胺氧化酶(DAO)、D-乳酸]水平;比较不同感染程度患者粪便球杆比、DAO及D-乳酸水平。结果 感染组肠道菌群失调率(58.33%),高于非感染组(21.67%),比较有统计学差异(P<0.05),感染组乳酸杆菌、双歧杆菌、拟杆菌菌落计数低于非感染组,而肠球菌、消化链球菌计数高于非感染组,比较均有统计学差异(P<0.05),感染组粪便球杆比(0.72±0.35)、血DAO(3.12±1.49)mg/L、D-乳酸(5.72±2.26)mg/L水平均高于非感染组(P<0.05),中重度感染患者粪便球杆比、血DAO、D-乳酸水平均高于轻度患者(P<0.05)。结论 脑胶质瘤术后肺部感染者存在肠道菌群失调及肠道屏障功能受损,表现出肠道粪便球杆比及血DAO、D-乳酸水平升高,且与患者肺部感染严重程度相关。OBJECTIVE To explore the relationship between intestinal microecological balance, barrier function and postoperative pulmonary infection in the glioma patients. METHODS From Jan 2018 to Dec 2020, a total of 60 glioma patients who were treated in neurosurgery department of the First Affiliated Hospital of Soochow University and had postoperative pulmonary infection were assigned as the infection group, meanwhile, 60 glioma patients who did not have postoperative infection were chosen as the non-infection group. The intestinal flora and intestinal barrier function indexes [diamine oxidase(DAO), D-lactic acid] were compared between the two groups of patients. The fecal coccus-bacillus ratio, DAO and D-lactic acid were compared among the patients with different degree of infection. RESULTS The rate of intestinal flora imbalance of the infection group was 58.33%, significantly higher than 21.67% of the non-infection group, and there was significant difference(P<0.05). The colony counts of Lactobacillus, Bifidobacterium and Bacteroides were less in the infection group than in the non-infection group, while the colony counts of Enterococcus and Peptostreptococcus were greater in the infection group than in the non-infection group, and there were significant differences(P<0.05). The fecal coccus-bacillus ratio, blood DAO and D-lactic acid of the infection group were respectively(0.72±0.35),(3.12±1.49)mg/L and(5.72±2.26)mg/L, significantly higher than those of the non-infection group(P<0.05);the fecal coccus-bacillus ratio, blood DAO level and D-lactic acid level of the patients with moderate and severe infection were significantly higher than those of the patients with mild infection(P<0.05). CONCLUSION The glioma patients with postoperative pulmonary infection have the intestinal flora imbalance and damage of intestinal barrier function, showing the rise of fecal coccus-bacillus ratio, blood DAO level and D-lactic acid level, which is associated with the severity of pulmonary infection.

关 键 词：脑胶质瘤 术后肺部感染 肠道微生物 菌群失调 肠道屏障功能 

分 类 号：R619.3[医药卫生—外科学]