摘要
目的探讨行自然腔道内镜手术(natural orifice transluminal endoscopic surgery,NOTES)保胆取石(或取息肉)治疗对胆囊良性病变患者肠道菌群的影响。方法纳入诊断为胆囊良性病变并拟行消化内镜下微创保胆治疗的患者15例,分别采集围手术期术前1周内和术后3个月内的粪便样本。利用Illumina Miseq测序平台,对细菌的16S rRNA基因V3~V4可变区进行高通量测序,并对测序结果进行生物信息学分析。结果患者术后3个月内与术前1周内肠道菌群相比,多样性显著减少,与营养代谢吸收相关的拟杆菌门显著增加,厚壁菌门/拟杆菌门(F/B)比率显著降低,肠道菌群结构仍存在明显差异,主要体现为:一些与胆汁酸代谢相关菌如脆弱拟杆菌(Bacteroides fragilis)显著增加;部分与肥胖相关的菌属如布雷德菌属(Bulleidia moorei)、长链多尔氏菌(Dorea longicatena)显著减少,部分与短链脂肪酸代谢相关菌如灵巧粪球菌(Coprococcus catus)、产气柯林斯菌(Collinsella aerofaciens)、甲酸芽殖菌(Gemmiger formicilis)、粪罗斯氏菌(Roseburia faecis)显著减少;部分有害菌如哈氏梭菌(Clostridium hathewayi)、韦荣氏球菌属(Veillonella)显著增加。结论胆囊良性疾病患者行NOTES保胆取石(或取息肉)治疗术后3个月内,肠道菌群多样性仍显著减少、胆汁酸代谢相关菌增加、短链脂肪酸产生菌减少、部分有害菌增加。总体上,肠道菌群尚未完全恢复,仍处于失调状态。
Objective To investigate the effect of natural orifice transluminal endoscopic surgery(NOTES)gallbladder preservation surgery on intestinal microbiota in patients with benign gallbladder diseases.Methods Fifteen patients with benign gallbladder diseases were enrolled,and stool samples were collected both within 1 week preoperatively(PR)and within 3 months postoperatively(PO).High-throughput sequencing targeting the V3-V4 variable region of the 16S rRNA gene using Illumina Miseq platform was conducted,followed by bioinformatics analysis of the sequencing data.Results Compared with PR stage,the diversity of intestinal microbiota decreased significantly at the PO stage,Bacteroides associated with nutrient metabolism and absorption increased significantly,while the Firmicutes/Bacteroidetes(F/B)ratio decreased significantly in PO stage.There were still obvious differences in intestinal microbiota structure between PR stage and PO stage.Some bacteria related with bile acid metabolism,such as Bacteroides fragilis,increased significantly.Some bacteria related to obesity,such as Bulleidia moorei and Dorea longicatena,decreased significantly.Some bacteria related to the metabolism of short chain fatty acids,such as Coprococcus catus,Collinsella aerofaciens,Gemmiger formicilis and Roseburia faecis,decreased significantly,while some conditionally pathogenic bacteria,such as Clostridium hathewayi and Veillonella,increased significantly.Conclusion Following-up investigations on patients with benign gallbladder diseases undergoing NOTES surgery for biliary stone(or polyps removal)within 3 months after surgery suggests that the diversity of intestinal microbiota is remained significantly reduced,and the abundance of bacteria related to bile acid metabolism is increased.The abundance of bacteria related to produce short chain fatty acids is reduced,and some harmful bacteria is increased.Overall,the intestinal microbiota has not yet fully recovered,and it is still in a state of imbalance.
作者
邓立新
吕新芝
黄清蓉
黄雪娟
陈艺玲
温慧萍
刘妍
唐庆林
王淘淘
温春虹
张鸣青
DENG Lixin;LYU Xinzhi;HUANG Qingrong;HUANG Xuejuan;CHEN Yiling;WEN Huiping;LIU Yan;TANG Qinglin;WANG Taotao;WEN Chunhong;ZHANG Mingqing(Department of Gastroenterology,the 909th Hospital of Joint Logistic Support Force,Dongnan Hospital of Xiamen University,Zhangzhou 363000,China)
出处
《胃肠病学和肝病学杂志》
CAS
2024年第4期417-425,共9页
Chinese Journal of Gastroenterology and Hepatology
基金
福建省自然科学基金(2021J01545)
漳州市科技拥军项目(ZZ2019KD01)
肿瘤生物学国家重点实验室(空军军医大学)开放课题(CBSKL201729)
漳州市自然科学基金项目(ZZ2021J25)。
