非酒精性脂肪肝患者的肠道菌群特点及其与肠道炎症的关系  

The characteristics of intestinal flora of patients with NAFLD and its relationship with intestinal inflammation

作　　者：苏沛珠 吴李贤[2] 李兆滔[1] 王艺霖[1] 徐慧娟 智发朝 何卉欣 SU Pei-zhu;WU Li-xian;LI Zhao-tao;WANG Yi-lin;XU Hui-juan;ZHI Fa-chao;HE Hui-xin(Department of Digestive Diseases,First People′s Hospital of Foshan,528000;Department of NAFLD,First People′s Hospital of Foshan,528000;Department of Digestive Diseases,Nanfang Hospital of Southern Medical University,510000)

机构地区：[1]佛山市第一人民医院消化内科,528000 [2]佛山市第一人民医院非酒精性脂肪肝中心,528000 [3]南方医院消化内科,510000

出　　处：《现代消化及介入诊疗》2022年第7期826-833,共8页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：广东省基础与应用基础研究基金项目(2019A1515110624);佛山市登峰计划项目(2019C014)。

摘　　要：目的探讨肠道菌群在非酒精性脂肪肝(NAFLD)中的作用及其与肠道炎症的关系。方法收集在佛山市第一人民医院NAFLD中心就诊的39例NAFLD患者及同期体检的31例健康人群大便,通过16srRNA检测及生物信息学分析;免疫荧光层析法检测粪便钙卫蛋白。结果NAFLD组与健康对照组相比,Simpson指数分别为0.95(0.90-0.96)及0.96(0.94-0.98)(P=0.027),Shannon指数分别为6.31(5.37-6.83)及6.84(5.94-7.45)(P=0.038),Pielou_e指数分别为0.66(0.59-0.70)及0.69(0.63-0.74)(P=0.032),Faith′s PD指数分别为36.06(32.03-44.01)及44.29(40.34-53.56)(P<0.001),显示NAFLD组上述指标均显著低于健康对照组。健康对照组中显著升高的细菌门有Bacteroidetes、Verrucomicrobia、Lentisphaerae、Tenericutes、Firmicutes(P<0.05),其中Bacteroidetes门是其中的关键物种。NAFLD组的粪便钙卫蛋白(26,18 IQR 59 vs 17.5,11.8 IQR 51.0)、Zonulin(4.60,2.72 IQR 6.80 vs 2.30,1.40 IQR 3.94)及TNFα(61.44,36.35 IQR 68.12 vs 38.22,24.11 IQR 45.74)均显著高于正常对照组(P<0.01)。结论NAFLD患者的肠道菌群生物多样性显著下降,其系统性炎症及肠道炎症显著高于正常人群。Objective To explore the role of intestinal flora in NALLD and its relationship with intestinal inflammation.Methods The stools of 39 NAFLD patients and 31 healthy people who underwent physical examination at the NAFLD center of Foshan First People′s Hospital were collected and analyzed by 16SrRNA detection and bioinformatics;Fecal calprotectin was detected by immunofluorescence chromatography.Results Compared with the healthy control group,Simpson index of NAFLD group was 0.95(0.90-0.96)and 0.96(0.94-0.98)(P=0.027),Shannon index was 6.31(5.37-6.83)and 6.84(5.94-7.45)(P=0.038),Pielou_E index was 0.66(0.59-0.70)and 0.69(0.63-0.74)(P=0.032),faith′s PD index was 36.06(32.03-44.01)and 44.29(40.34-53.56)(P<0.001),indicating that the above indicators in NAFLD group were significantly lower than those in healthy control group.Bacteroidetes,verrucomicrobia,lentisphaerae,tenericutes,Firmicutes were significantly increased in the healthy control group(P<0.05),among which Bacteroidetes was the key species.Fecal calprotectin(26,18 IQR 59 vs 17.5,11.8 IQR 51.0),zonulin(4.60,2.72 IQR 6.80 vs 2.30,1.40 IQR 3.94)and TNFα(61.44,36.35 IQR 68.12 vs 38.22,24.11 IQR 45.74)in NAFLD group were significantly higher than those in normal control group(P<0.01).Bacteroidetes,verrucomicrobia,lentisphaerae,tenericutes,Firmicutes were significantly increased in the healthy control group(P<0.05),among which Bacteroidetes was the key species.Fecal calprotectin(26,18 IQR 59 vs 17.5,11.8 IQR 51.0),zonulin(4.60,2.72 IQR 6.80 vs 2.30,1.40 IQR 3.94)and TNFα(61.44,36.35 IQR 68.12 vs 38.22,24.11 IQR 45.74)in NAFLD group were significantly higher than those in normal control group(P<0.01).Conclusion The biodiversity of intestinal flora in NAFLD patients decreased significantly,and their systemic inflammation and intestinal inflammation were significantly higher than those in healthy people.

关 键 词：非酒精性脂肪肝 肠道菌群 粪便钙卫蛋白 肠道炎症 

分 类 号：R575[医药卫生—消化系统]