基于16S rDNA检测的肠道菌群移植对慢传输型便秘的作用研究

刘小倩; 王志; 周培华; 王丙开; 刘晓静; 蒋学军; 袁方均

doi:10.7619/jcmp.20230575

基于16S rDNA检测的肠道菌群移植对慢传输型便秘的作用研究

刘小倩^{1, 2},
王志²,
周培华²,
王丙开²,
刘晓静^{1, 2},
蒋学军²,
袁方均^{1, 2, ,}

1.
锦州医科大学国药东风总医院研究生培养基地胃肠外科, 湖北十堰, 442000
2.
湖北医药学院附属国药东风总医院胃肠外科, 湖北十堰, 442000

基金项目:

湖北省教育厅科学研究计划指导性项目 B2020108

详细信息

通讯作者:
袁方均, E-mail: Yuanfangjun@126.com

中图分类号: R442.2;R378.2
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出版历程
- 收稿日期: 2023-02-26
- 修回日期: 2023-04-29
- 网络出版日期: 2023-05-24
- 刊出日期: 2023-05-14

Role of fecal microbiota transplantation in treating slow transit constipation based on 16S rDNA detection

1.
Department of Gastrointestinal Surgery, Graduate Educational Base of Dongfeng General Hospital of Sinopharm of Jinzhou Medical University, Shiyan, Hubei, 442000
2.
Department of Gastrointestinal Surgery, Dongfeng General Hospital of Sinopharm Affiliated to Hubei University of Medicine, Shiyan, Hubei, 442000

摘要

摘要:
目的
通过16S rDNA检测技术探讨慢传输型便秘(STC)患者肠道菌群特点以及肠道菌群移植(FMT)的作用。
方法
选取30例STC患者作为STC组，给予2个疗程的规范化FMT治疗; 选取同期20例健康成年人作为对照组。采用粪便16S rDNA测序技术对STC组和对照组肠道菌群进行比较，并对STC患者实施FMT前后的肠道菌群进行比较。
结果
与对照组相比, STC组肠道菌群多样性降低，厚壁菌门相对丰度降低，而变形菌门和梭杆菌门相对丰度升高，差异均有统计学意义(P < 0.05)。经FMT治疗后，功能性便秘患者菌群多样性升高，差异有统计学意义(P < 0.05); 在门水平上, STC患者实施FMT后拟杆菌门和梭状菌门相对丰度降低，而厚壁菌门和变形菌门相对丰度升高，差异有统计学意义(P < 0.05)。STC组胃肠生活质量评分(GIQLI)、Wexner便秘评分均较治疗前下降，差异有统计学意义(P < 0.05)。STC组抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分、匹兹堡睡眠质量评分(PSQI)均较治疗前下降，差异有统计学意义(P < 0.05)。
结论
STC患者肠道菌群易发生紊乱，菌群多样性及分布发生改变。FMT可通过调节肠道菌群来改善便秘症状，改变肠道菌群的分布和多样性。
- 慢传输型便秘 /
- 肠道菌群 /
- 肠道菌群移植 /
- 16S rDNA检测技术
Abstract:
Objective
To investigate the characteristics of intestinal flora in patients with slow transit constipation (STC) and role of fecal microbiota transplantation (FMT) by 16S rDNA sequencing technology.
Methods
A total of 30 patients with STC were selected as STC group, and they were treated with standardized FMT therapy for two courses; another 20 healthy adults in the same period were selected as control group. Fecal 16S rDNA sequencing technology was used to compare the intestinal flora between the control group and the STC group, and the intestinal flora before and after FMT in patients with STC was compared.
Results
Compared with the control group, the diversity of intestinal flora in the STC group decreased significantly, the relative abundance of Firmicutes decreased significantly, and the relative abundances of Proteobacteria and Fusobacteria increased significantly (P < 0.05). After FMT treatment, the diversity of flora in patients with functional constipation increased significantly (P < 0.05); at the phylum level, the relative abundances of Bacteroidetes and Fusobacteria decreased significantly while the relative abundances of Firmicutes and Proteobacteria increased significantly in STC patients after implementing FMT (P < 0.05). The Gastrointestinal Quality of Life Index (GIQLI) score and Wexner constipation score in the STC group decreased significantly after treatment when compared to those before treatment (P < 0.05). The Self-rating Depression Scale (SDS) score, Self-rating Anxiety Scale (SAS) score and Pittsburgh Sleep Quality Index (PSQI) score in the STC group decreased significantly after treatment when compared to those before treatment (P < 0.05).
Conclusion
STC patients are prone to disruption of intestinal flora, resulting in changes of microbial diversity and distribution. FMT can improve constipation symptoms and change the distribution and diversity of intestinal flora by regulating intestinal flora.
- slow transit constipation /
- intestinal flora /
- fecal microbiota transplantation /
- 16S rDNA sequencing technology

HTML全文

图 1 STC组和对照组菌群多样性及各个菌门相对丰度比较

A: 菌群多样性比较; B: 各个菌门相对丰度比较。

下载: 全尺寸图片幻灯片

图 2 STC患者实施FMT前后与对照组菌群多样性及各个菌门相对丰度比较

A: 菌群多样性比较; B: 各个菌门相对丰度比较。

下载: 全尺寸图片幻灯片

表 1 STC组和对照组粪便菌群比较(x ± s[M(IQR)]

组别	菌群多样性	厚壁菌门	拟杆菌门	变形菌门	放线菌门	梭杆菌门
STC组	2.00±0.76	0.29±0.24	0.34±0.25	0.25±0.20	0.03(0.01~0.05)	0.01(0~0.07)
对照组	2.84±0.84^*	0.45±0.21^*	0.37±0.28	0.12±0.11^*	0.05(0.01~0.07)	0.02(0~0.01)^*
与STC组比较, *P<0.05。

下载: 导出CSV

表 2 STC患者FMT前后粪便菌群比较(x ± s)[M(IQR)]

时点	菌群多样性	厚壁菌门	拟杆菌门	变形菌门	放线菌门	梭杆菌门
FMT前	2.00±0.76	0.29±0.24	0.34±0.25	0.25±0.20	0.03(0.01~0.05)	0.01(0~0.07)
FMT后	2.60±0.47^*	0.47±0.11^*	0.10±0.10^*	0.33±0.16^*	0.04(0.01~0.09)	0(0~0.02)^*
与FMT前比较, *P<0.05。

下载: 导出CSV

表 3 STC患者实施FMT前后精神心理评估及疗效评估(x ± s) 分

时点	SDS评分	SAS评分	PSQI	GIQLI	Wexner便秘评分
FMT前	44.73±9.18	44.50±7.62	10.03±3.98	66.63±16.36	15.17±1.49
FMT后	39.03±8.20^*	35.77±7.47^*	8.23±2.70^*	50.40±16.13^*	2.27±1.14^*
SDS: 抑郁自评量表; SAS: 焦虑自评量表; PSQI: 匹兹堡睡眠质量评分; GIQLI: 胃肠生活质量指数。与FMT前比较, *P<0.05。

下载: 导出CSV

表 4 STC患者实施FMT前后BMI和血检指标比较(x ± s)

时点	BMI/(kg/m²)	RBC/(×10¹²/L)	WBC/(×10⁹/L)	ALT/(U/L)	AST/(U/L)	CREA/(μmol/L)	UREA/(mmol/L)
FMT前	22.27±2.08	4.12±0.62	4.27±0.68	16.14±6.14	30.03±8.88	66.97±10.45	4.70±1.19
FMT后	22.30±2.02	4.14±0.55	4.29±0.51	14.57±4.17	28.03±5.88	66.67±9.85	4.49±0.93

下载: 导出CSV

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