糖尿病肾移植患者术后早期肠道益生菌丰度变化及其对临床预后的影响  

Changes in intestinal probiotic abundance in diabetic kidney transplant recipients in the early postoperative period and their impact on clinical prognosis

作　　者：韩健乐 王晓勃[1] 殷正伟 李涛 杨俊伟[1] 杨帅平[1] 索敬钧 HAN Jianle;WANG Xiaobo;YIN Zhengwei;LI Tao;YANG Junwei;YANG Shuaiping;SUO Jingjun(Department of Renal Transplantation and Nephrology,The 7th People′s Hospital of Zhengzhou,Zhengzhou 450017,Henan,P.R.China)

机构地区：[1]郑州市第七人民医院肾移植肾内科,河南郑州450017

出　　处：《滨州医学院学报》2024年第6期487-490,共4页Journal of Binzhou Medical University

摘　　要：目的探究糖尿病肾移植患者术后早期肠道益生菌丰度变化及其对临床预后的影响。方法选择同种异体肾移植的50例非糖尿病患者为对照组,选择同期接受同种异体肾移植的72例糖尿病患者为研究组,再将研究组患者分为非治疗组(n=36)和治疗组(n=36),治疗组接受益生菌制剂及益生元治疗。比较肾移植术前术后入组患者的肠道益生菌丰度变化,比较治疗组和非治疗组接受益生菌制剂及益生元治疗前后的肠道益生菌丰度差异,随访治疗组和非治疗组患者治疗后7和14 d的肾功能指标差异,并将研究组患者按照是否出现并发症进一步区分亚组,比较不同亚组患者肠道益生菌丰度差异。结果研究组在肾移植术后的梭状菌、单形拟杆菌丰度占比高于对照组(P<0.05),而研究组在肾移植术后的脆弱拟杆菌、卵形拟杆菌、益生芽孢杆菌丰度占比低于对照组(P<0.05)。治疗组接受益生菌制剂及益生元治疗后7及14 d粪便样本中的大肠杆菌、梭状菌、Blautia菌、多形拟杆菌、卵形拟杆菌、吉氏拟杆菌丰度占比低于非治疗组(P<0.05),而治疗组治疗后7及14 d的双歧杆菌、嗜酸乳杆菌丰度占比高于非治疗组(P<0.05)。治疗组术后7、14 d的BNU、Cr、Cys-C以及PCT水平均低于非治疗组(P<0.05),但仍高于对照组(P<0.05)。随访1个月,三组间胃肠道反应发生率比较,P<0.05或<0.01,治疗组腹胀、腹泻以及便秘发生率低于非治疗组。结论肾移植手术会加重糖尿病患者肠道益生菌失调状态,对患者的术后肾功能恢复有一定影响。可以考虑从调节患者肠道益生菌丰度入手,改善肾移植患者的预后状态。Objective To explore the early postoperative changes of intestinal probiotics abundance and its impact on clinical prognosis in diabetic renal transplant recipients.Methods Fifty non-diabetic recipients of allogeneic kidney transplants from June 2019 to October 2022 were selected as the control group,and 72 diabetic patients who received allogeneic kidney transplants during the same period were selected as the study group.Then the patients in the study group were divided into the non-treatment group(n=36)and the treatment group(n=36),and the treatment group received probiotics and prebiotics treatment.The changes in probiotic abundance in patients enrolled in the group were compared before and after the surgery,and the differences in intestinal probiotic abundance between the treated and non-treated groups before and after receiving probiotic preparations and prebiotics were compared,and the differences in renal function indicators between the treated and non-treated groups at 7 and 14 days after the treatment were compared.Then the patients in the study group were further divided into subgroups according to the presence or absence of complications,and the differences in intestinal probiotic abundance between the different subgroups were compared.Results The abundance of Clostridium and Bacteroides uniformis in the study group was higher than that in the control group(P<0.05),while the abundance of Bacteroides fragilis,Bacteroides ovatus,and Bacillus probioticus was lower in the study group than that in the control group(P<0.05).After the treatment with probiotics and prebiotics,the abundance of Escherichia coli,Clostridium,Blautia,Bacteroides thetaiotaomicron,Bacteroides ovatus,and Bacteroides vulgatus in the treatment group′s fecal samples at 7 and 14 days was lower than that in the non-treatment group(P<0.05),while the abundance of Bifidobacterium and Lactobacillus acidophilus was higher in the treatment group than that in the non-treatment group(P<0.05).The levels of BUN,Cr,Cys-C,and PCT in the treatment gr

关 键 词：肠道菌群丰度 糖尿病 肾移植 

分 类 号：R692[医药卫生—泌尿科学]