饮食干预对肿瘤患者放疗期间胃肠道毒性和肠道菌群的关联研究  

Diet intervention and its association with gastrointestinal toxicity and gut microbiota in cancer patients during radiotherapy

作　　者：周婵 郝丽琼[1] 文成玉[1] 吴师容 ZHOU Chan;HAO Liqiong;WEN Chengyu;WU Shirong(Sichuan Cancer Hospital,Chengdu 61004l,China)

机构地区：[1]四川省肿瘤医院,四川成都610041

出　　处：《中国病原生物学杂志》2025年第1期19-24,共6页Journal of Pathogen Biology

基　　金：四川省科学技术项目(No.2024JDKPO181)。

摘　　要：目的本研究旨在评估饮食干预对接受放疗的肿瘤患者胃肠道毒性的影响,并探讨其与肠道菌群变化的相关性。方法120名肿瘤患者随机分配至对照组(仅放疗)和实验组(放疗加饮食干预)。通过比较两组患者的血红蛋白、白蛋白、前白蛋白水平,评估营养状况;记录大便频率、形态、止泻药使用情况及呕吐情况,评估胃肠道毒性;检测CD4^(+)T细胞、CD8^(+)T细胞和NK细胞,评估免疫功能。利用高通量测序分析肠道菌群组成,并进行相关性分析。结果实验组在放疗后血红蛋白水平显著升高(P<0.001),前白蛋白水平保持稳定(P>0.05),而对照组前白蛋白水平显著降低(P<0.001)。实验组的胃肠道毒性反应较对照组有显著改善,包括大便频率(P<0.05)、大便形态(P<0.05)、止泻药使用次数减少(P<0.05)和呕吐情况减轻(P<0.05)。免疫功能方面,实验组的CD4^(+)T细胞、CD8^(+)T细胞和NK细胞数量相对稳定,差异无统计学意义(P>0.05)。肠道菌群分析显示,实验组菌群多样性和丰富度较对照组提高,其中Actinobacteria和Firmicutes与较低的胃肠道毒性负相关(P<0.05),而Proteobacteria、Bacteroidetes和Verrucomicrobia与某些毒性症状正相关(P<0.05)。结论饮食干预对于改善肿瘤患者放疗期间的营养状况和减轻胃肠道毒性具有积极作用,并且通过调节肠道菌群组成,对免疫功能产生正面影响。这些发现为放疗患者的个性化饮食管理和肠道健康提供了科学依据。Objective This study aimed to evaluate the impact of dietary intervention on gastrointestinal toxicity in cancer patients undergoing radiotherapy and to explore its correlation with changes in gut microbiota.Methods A total of 120 cancer patients were randomly assigned to the control group(radiotherapy only)and the experimental group(radiotherapy plus dietary intervention).Nutritional status was assessed by comparing hemoglobin,albumin,and prealbumin levels between the two groups.Gastrointestinal toxicity was evaluated by recording stool frequency,consistency,the use of antidiarrheal medication,and vomiting conditions.Immune function was assessed by detecting CD4^(+)T cells,CD8^(+)T cells,and NK cells.Gut microbiota composition was analyzed using high-throughput sequencing and correlation analysis was performed.Results Post-radiotherapy,the experimental group showed a significant increase in hemoglobin levels(P<0.001),with prealbumin levels remaining stable(P>0.05),while the control group exhibited a significant decrease in prealbumin levels(P<0.001).The experimental group experienced significant improvements in gastrointestinal toxicity compared to the control group,including stool frequency(P<0.05),stool consistency(P<0.05),reduced use of antidiarrheal medication(P<0.05),and alleviated vomiting(P<0.05).In terms of immune function,the numbers of CD4^(+)T cells,CD8^(+)T cells,and NK cells in the experimental group remained relatively stable with no significant changes(P>0.05).Gut microbiota analysis revealed that the experimental group had increased diversity and richness compared to the control group.Actinobacteria and Firmicutes were negatively correlated with lower gastrointestinal toxicity(P<0.05),while Proteobacteria,Bacteroidetes,and Verrucomicrobia were positively correlated with certain toxicity symptoms(P<0.05).Conclusion Dietary intervention plays a positive role in improving the nutritional status of cancer patients during radiotherapy and reducing gastrointestinal toxicity,and it positively affects im

关 键 词：饮食干预 肿瘤患者 放疗 胃肠道毒性 肠道菌群 

分 类 号：R730.55[医药卫生—肿瘤]