顽固性便秘患者金陵术前后肠道菌群变化的研究

Changes of gut microbial population in patients with constipation by Jinling's procedure

目的研究顽固性便秘患者粪便和结肠黏膜菌群在行金陵术切除大部结肠前后的改变。方法采集健康人群及顽固性便秘患者术前、术后6个月粪便和结肠黏膜样本,提取总细菌核酸,应用实时荧光定量PCR技术对样本中优势菌群进行定量分析。结果定量PCR结果显示顽固性便秘组粪便及黏膜样本优势菌群数量较健康人群无显著区别(P>0.05);粪便样本中双歧杆菌属、乳酸杆菌属明显低于正常人群(P<0.05),黏膜样本中双歧杆菌明显低于正常人群(P<0.05)。术后6个月粪便样本中优势菌群数量较术前显著降低(P<0.05),黏膜优势菌群数量无显著变化(P>0.05),粪便及黏膜样本中双歧杆菌属和乳酸杆菌属的数量较术前显著上升(P<0.05),达到或接近正常人群水平。便秘组粪便样本中甲烷菌数量与正常对照组无显著区别(P>0.05);术后较术前也无显著变化(P>0.05),但显著少于正常对照组(P<0.05)。便秘组黏膜样本中甲烷菌数量显著少于正常对照组(P<0.05),术后则显著增多(P<0.05),达到正常对照组水平。结论金陵术外科治疗顽固性便秘缓解患者症状的同时,有助于结肠菌群结构恢复正常。

Objective To investigate the changes of microbia in fecal and mucous membrane of the colon in patients with constipation treated by Jinling＇s procedure.Methods Feces and mucosal samples of healthy volunteers and constipation patients were collected 6 months before and after Jinling＇s procedure,and total bacterial DNA was extracted,and real-time PCR was employed for quantitative analysis.Results Real-time PCR analysis showed no significant difference in predominant bacteria in feces and mucosa between patients with constipation and healthy volunteers（P0.05）.In fecal samples,bifidobacterium and cillobacterium of patients with constipation were significantly less than those of healthy volunteers（P0.05）.In mucosal samples,bacillus bifidus of constipation patients was less than that of healthy volunteers（P0.05）.Compared with preoperative data 6 months after operation,predominant bacteria decreased significantly in fecal samples（P0.05）,while no significant change could be observed in mucosal samples（P0.05）.Bifidobacteria and lactobacilli in fecal and mucosal samples increased after operation（P0.05）,and were comparable to those in healthy volunteers.Methanogens in fecal samples of constipation patients showed no significant difference compared with healthy volunteers（P0.05）and remained stable after operation（P0.05）.Methanogens in mucosal samples of patients with constipation were less than those of healthy volunteers（P0.05）,but they increased postoperatively（P0.05） and returned to normal level.Conclusions With effective clinical outcome in treating patients with constipation,Jinling＇s procedure might also be contributive to the recovery of the intestinal flora.