乙型肝炎肝硬化腹水合并自发性细菌性腹膜炎患者肠道菌群特征  

Characteristics of intestinal flora in patients with hepatitis B cirrhosis with ascites combined with spontaneous bacterial peritonitis

作　　者：李丹[1] 胡萌[1] 张冬 卓永祥 申弘 翟昌明 王文辉 田广俊[1] LI Dan;HU Meng;ZHANG Dong;ZHUO Yongxiang;SHEN Hong;ZHAI Changming;WANG Wenhui;TIAN Guangjun(Department of Hepatology,Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine,Zhuhai,Guangdong 519015,China;不详)

机构地区：[1]广东省中医院珠海医院肝病科,广东珠海519015 [2]澳门大学中华医药研究院,广东珠海519015 [3]北京中医药大学生命科学学院,广东珠海519015

出　　处：《中国微生态学杂志》2023年第11期1303-1310,共8页Chinese Journal of Microecology

基　　金：广东省中医药局科研项目(20203008);广东省中医药局名中医师承项目(粤中医函[2015]20号)。

摘　　要：目的 初步分析乙型肝炎肝硬化腹水合并自发性细菌性腹膜炎(SBP)患者肠道菌群特征,为该类患者的治疗提供参考。方法 选取我院符合纳入标准的乙型肝炎肝硬化腹水患者45例为研究对象,其中24例合并SBP的患者为SBP组、21例未合并SBP的患者为NSBP组,另选同期20例健康人为HC组。应用16S rDNA测序技术检测患者肠道菌群,并使用生物信息学方法分析各组对象肠道菌群变化。结果 SBP组、NSBP组及HC组相比,其肠道菌群的物种多样性及丰富度差异均无统计学意义(均P<0.05)。PCoA分析显示,NSBP组与HC组患者肠道菌群结构相似,SBP组与其他两组相比菌群结构较为不同。与NSBP组相比,SBP组患者肠道菌群中变形菌门(Proteobacteria,5.45%vs 13.50%,U=161.000,P=0.038)、软壁菌门(Tenericutes,0.019%vs 0.073%,U=162.000,P=0.035)、埃希—志贺菌属(Escherichia-Shigella,0.24%vs9.53%, U=103.000, P=0.001)、柠檬酸杆菌属(Citrobacter, LDA> 2)等丰度均增加;酸杆菌门(Acidobacteria,0.026%vs 0.015%,U=152.000,P=0.023)、罗氏菌属(Roseburia,2.55%vs 2.00%,U=152.000,P=0.023)、粪球菌属(Coprococcus,LDA>2)等丰度下降。结论 乙型肝炎肝硬化腹水的发生发展与肠道菌群密切相关,在SBP患者肠道菌群中发现潜在病原体数量显著增加,并伴随有益细菌数量的减少。Objective To preliminarily analyze the characteristics of intestinal microbiota in patients with hepatitis B virus (HBV)-related cirrhotic ascites (CA) complicated by spontaneous bacterial peritonitis (SBP), providing a reference for the treatment. Methods Forty-five patients with HBV-related CA who met the inclusion criteria were selected, including 24 patients with SBP (SBP group) and 21 without SBP (NSBP group). Additionally, 20 healthy individuals were selected as the healthy control (HC group). The intestinal flora was examined using 16S rDNA sequencing technology, and bioinformatics methods were employed to analyze the variations in the intestinal microbiota among the groups. Results There were no significant differences in species diversity and richness of intestinal flora among SBP, NSBP and HC groups. The principal coordinates analysis (PCoA) results showed that the microbial structure of the NSBP group was similar to that of the HC group, while SBP group was differed significantly from the other two groups. Compared to the NSBP group, the SBP group exhibited increased abundances of Proteobacteria (5.45% vs 13.50%, U = 161.000, P = 0.038), Tenericutes (0.019% vs 0.073%, U = 162.000, P = 0.035), Escherichia-Shigella (0.24% vs 9.53%, U = 103.000, P = 0.001), Citrobacter (LDA>2) and other taxa;however, the abundances of Acidobacteria (0.026% vs 0.015%, U = 152.000, P = 0.023), Roseburia (2.55% vs 2.00%, U = 152.000, P = 0.023), Coprococcus (LDA>2), and other taxa decreased. Conclusion The occurrence and development of HBV-related CA are closely related to the intestinal microbiota. In patients with SBP, a significant increase in potential pathogens and a decrease in beneficial bacteria were observed in the intestinal microbiota.

关 键 词：乙型肝炎肝硬化腹水 自发性细菌性腹膜炎 肠道菌群 16S rDNA测序技术 

分 类 号：R575.2[医药卫生—消化系统]