婴儿肠道菌群与分娩方式、喂养方式及胆汁淤积性肝病的关系

Relationship between Intestinal Flora of Infants,Delivery and Feeding Modes and Cholestatic Liver Disease

目的分析分娩方式和喂养方式对健康婴儿肠道菌群的影响,探讨肠道相关分子微生态在胆汁淤积性肝病中的作用及意义。方法收集37例健康婴儿(其中阴道分娩21例,剖宫产16例;母乳喂养15例,人工喂养22例)及84例胆汁淤积性肝病婴儿粪便,提取粪便中细菌DNA并测量A260值;应用实时荧光定量PCR反应测定粪便中双歧杆菌、乳酸杆菌及大肠杆菌3种代表菌的数量。结果阴道分娩婴儿与剖宫产婴儿比较,母乳喂养婴儿与人工喂养婴儿比较,粪便标本中细菌DNA A260值和3种代表菌数量差异均无统计学意义(Pa>0.05)。健康对照组与胆汁淤积性肝病组粪便标本中细菌的DNA A260值分别为(1.94±0.47)g.L-1和(0.40±0.09)g.L-1,2组比较差异有统计学意义(t=8.91,P=0.00);健康对照组与胆汁淤积性肝病组3种细菌数(lg拷贝数/g湿便)的对数值比较差异均有统计学意义(双歧杆菌9.49±0.59 vs 7.68±0.57;t=15.96,P=0.00;乳酸杆菌8.58±0.32 vs 8.16±0.70;t=3.46,P=0.00;大肠杆菌6.87±0.67 vs 7.26±0.86;t=-2.41,P=0.02)。结论不同的分娩方式、喂养方式对婴儿期肠道菌群无影响;胆汁淤积性肝病婴儿肠道菌群与健康婴儿不同,粪便中细菌总量减少,双歧杆菌及乳酸杆菌数量明显减少,大肠杆菌的数量则明显增多,提示肠道菌群失调与婴儿胆汁淤积性肝病的发生、发展有一定关系。

Objective To analyze the influence of delivery and feeding modes on intestinal flora of healthy infants and investigate the role and significance of the molecular microbial ecology related to intestinal canal in the cholestatic liver disease. Methods Thirty - seven cases of healthy infants （including 21 cases of vaginal delivery, 16 cases of caesarean birth;15 cases of breast - feeding,22 cases of bottle - feeding） and 84 cases of cholestatic liver disease were selected, and their stool were collected, the bacterial DNA in the stool between the both groups and A260 value was measured, and the numbers of the 3 kinds of representative bacteria of bifidobaeterium, laetobaeillus and escherichia coli were determined by applying real - time fluorescent PCR. Results In comparison of the delivery infants to caesarean infants and breast - feeding infants to bottle -feeding infants, the bacterial DNA A260 value in stool specimen and the numbers of the 3 kinds of representative bac- teria had no statistically significant difference （ Pa 〉 0.05 ）. The bacterial DNA A260 value in the stool specimen in the healthy control group and cholestatic liver disease group were （ 1. 94 ± 0.47 ） g ·L^-1 and （0.40 ± 0.09 ） g ·L^-1, respectively, there was statistically significant difference between both groups（ t = 8.91 ,P = 0.00 ） ; log value of the numbers of 3 kinds of representative bacteria in healthy control group and cholestatic liver disease group were ： bifidobacterium 9.49 ± 0.59 vs 7.68 ± 0.57 ; lactobacillus 8.58 ±0.32 vs 8.16 ± 0.70 ; escherichia coli 6.87 ± 0.67 vs 7.26 ± 0.86, respectively. In comparison of the 3 kinds of representative bacteria in both groups had statistically significant difference（t = 15.96,3.46, -2.41;P =0.00,0.00,0.02）. Conclusions Different modes of delivery and feeding had no influence on intes- tinal flora of healthy infants;the intestinal flora of infants with cholestatic liver disease is different from that of healthy infants,total bacteria in the stool of the former decrease, the numbers of bifldobacterium and lactobacillus significantly decrease, whereas the number of escherichia coli significantly increases,which suggests that the occurrence and development of cholestatic liver disease of infants have a certain relationship with the intestinal flora.