主动脉夹层手术前后患者肠道菌群结构特征变化的研究

Changes of the gut microbiome in chinese patients before and after surgery of thoracic aortic dissection

目的:初步探讨主动脉夹层手术前后患者胃肠道症状与肠道菌群结构特征间的关系。方法:收集北京安贞医院心脏外科,行主动脉夹层手术患者的粪便标本,提取细菌DNA,采用16S rDNA基因扩增和Illumina测序技术将细菌归类。结果:术前组(17例)和术后组(11例)胃肠道症状评分分别为[(35.5±2.2)vs.(40.6±3.5)分,P<0.001]。术前组和术后组门水平肠道菌群结构中位数分别为:厚壁菌门(66.1%vs.45.0%,P=0.086);拟杆菌门(20.6%vs.40.4%,P=0.041);放线菌门(0.7%vs.1.5%,P=0.359);变形菌门(3.6%vs.5.4%,P=0.312)。Spearman相关性分析结果显示,胃肠道症状评分与拟杆菌门比例呈正相关,(r=0.386,P=0.042)。结论:主动脉夹层手术治疗前后患者胃肠道症状的发生与肠道菌群结构改变有一定相关性,这可能为患者益生菌治疗胃肠道症状提供理论依据。

Objective： To investigate the changes of gut microbiome in Chinese patients before and after the surgery of thoracic aortic dissection（TAAD）, and to explore the relationship between the gastrointestinal symptoms and gut microbiome. Methods： Fecal specimens of patients undergoing surgery of TAAD were collected from heart surgery center of Beijing Anzhen Hospital. Themicrobial DNA was extracted from the fecal samples and the bacteria were classified by 16 s rDNA gene amplification and Illumina sequencing. Results： 17 fecal samples were collected before operation and 11 cases after operation. There was no significant difference in gender, age and hospital stay between the two groups. The scores of gastrointestinal symptom rating scale（GSRS） in preoperative and postoperative groups were [（35.5±2.2）vs.（40.6±3.5）scores,P〈0.001]. The percentage median values of gut microbiome in preoperative and postoperative groups at the phylum level were Firmucutes 66.1% and 45.0%,（P=0.086）, Bacteroidetes 20.6% and 40.4%（P=0. 041）, Actinobacteria 0.7% and 1.5%（P=0.359）, Proteobacteria 3.6% and 5.4%（P=0.312）. Spearman correlation analysis showed significantly positive correlation between GSRS score and Bacteroidetes level（r=0.386, P=0.042）. Conclusion： The changes of gut microbiome in Chinese patients before and after surgery of TAAD is related to the appearance of gastrointestinal symptoms. Our research may provide evidence for postoperative probiotics treatment of gastrointestinal symptoms.