基于肠道菌群培养及鉴定技术探讨肠道菌群变化与老年慢性肾衰竭的相关性  

Exploring the correlation between gut microbiota changes and chronic renal failure in the elderly based on gut microbiota cultivation and identification techniques

作　　者：马玉杰 鲁新[1] 房若文 MA Yujie;LU Xin;FANG Ruowen(Department of Nephrology,Jilin People’s Hospital,Jilin 132001,Jilin,China;Department of Pathology,Jilin People’s Hospital,Jilin 132001,Jilin,China)

机构地区：[1]吉林市人民医院肾内科,吉林吉林132001 [2]吉林市人民医院病理科,吉林吉林132001

出　　处：《中国现代医生》2025年第12期10-13,121,共5页China Modern Doctor

基　　金：吉林省卫生健康科技能力提升项目(2021LC121)。

摘　　要：目的探讨肠道菌群变化与老年慢性肾衰竭(chronic renal failure,CRF)发生的相关性,为老年CRF的防治提供理论依据。方法选取2021年6月至2023年6月吉林市人民医院肾内科收治的57例老年CRF患者作为观察组,另选取同期65名健康体检者作为对照组。比较两组纳入者的基线资料、肠道菌群组成及血清生化指标。结果观察组患者的γ–谷氨酰转移酶、肌酐、尿素、尿酸、N–末端前体脑钠肽、甲状旁腺激素、超敏C反应蛋白和血磷高于对照组,血钙低于对照组,差异有统计学意义(P<0.05);观察组和对照组纳入者的菌门均以厚壁菌门和拟杆菌门为主,观察组患者中厚壁菌门和拟杆菌门的比例为49.22%和43.12%,对照组分别为49.47%和42.01%;菌属均以拟杆菌属为主,分别为8.69%和9.68%。多因素非条件Logistic回归分析结果显示放线菌门(95%CI:0.015~0.391,P=0.002)、乳杆菌属(95%CI:0.224~0.577,P<0.001)、双歧杆菌属(95%CI:0.150~0.933,P=0.035)、链球菌属(95%CI:0.256~0.687,P=0.001)与老年CRF的发生呈负相关,梭菌属(95%CI:2.176~15.047,P<0.001)和肠球菌属(95%CI:1.579~7.224,P=0.002)与其发生呈正相关。结论肠道菌群变化与老年CRF的发生密切相关,临床上应重视该人群的肠道菌群培养及鉴定,以便为诊治CRF患者肠道菌群失调、指导益生菌应用、制订微生态调节方案提供指导依据。Objective To explore the correlation between changes in gut microbiota and the occurrence of chronic renal failure(CRF)in elderly patients,providing theoretical evidence for the prevention and treatment of CRF in the elderly.Methods A total of 57 elderly patients with CRF admitted to Department of Nephrology,Jilin People’s Hospital from June 2021 to June 2023 were selected as observation group,while 65 healthy individuals who underwent physical examinations at the same hospital during the same period were chosen as control group.Baseline data,gut microbiota composition,and biochemical indicators were compared between two groups.Results The levels ofγ-glutamyl transferase,creatinine,urea,uric acid,N-terminal pro-brain natriuretic peptide,parathyroid hormone,hypersensitive C-reactive protein,and serum phosphorus were higher in observation group than those in control group,whereas serum calcium was lower;all differences were statistically significant(P<0.05).Firmicutes and Bacteroidetes were dominant in two groups,accounting for 49.22%and 43.12%in observation group and 49.47%and 42.01%in control group,respectively.At the genus level,Bacteroides predominated,comprising 8.69%and 9.68%of the total,respectively.Multivariate Logistic regression analysis showed that Actinobacteria(95%CI:0.015-0.391,P=0.002),Lactobacillus(95%CI:0.224-0.577,P<0.001),Bifidobacterium(95%CI:0.150-0.933,P=0.035),and Streptococcus(95%CI:0.256-0.687,P=0.001)were negatively associated with the occurrence of CRF in the elderly,whereas Clostridium(95%CI:2.176-15.047,P<0.001)and Enterococcus(95%CI:1.579-7.224,P=0.002)were positively associated.Conclusion Changes in gut microbiota are closely related to the development of CRF in the elderly.Clinically,attention should be paid to the cultivation and identification of gut microbiota in this population,in order to provide guidance for the diagnosis and treatment of intestinal flora disorders in patients with CRF,guide probiotic application,and formulate microecological regulation programs.

关 键 词：慢性肾衰竭 肠道菌群 老年人 培养 鉴定 

分 类 号：R692.5[医药卫生—泌尿科学] R592[医药卫生—外科学]