无症状胆囊结石患者肠道菌群的分布情况及其临床意义

Distribution of gut microbiota in asymptomatic patients with gallstones and its clinical significance

[目的]探讨无症状胆囊结石患者肠道菌群的分布情况及其临床意义。[方法]选取2014年1月~2018年1月我院外科收治的51例无症状胆囊结石患者为研究对象,另选择55例健康志愿者作为对照组。胆囊结石与健康个体的肠道菌群分别以其各自粪便菌群作为代表,肠道菌群以传统培养方法选择性培养并进行定量分析;肠道菌群的构成和组分根据微生物群落进行高通量测序结果进行分析。[结果]细菌培养结果显示胆囊结石患者粪便中肠杆菌和肠球菌含量明显增加,肠杆菌含量增加差异有统计学意义(P<0.05)。胆囊结石患者中双歧杆菌和乳酸菌的含量明显下降,乳酸菌含量减少差异有统计学意义(P<0.05)。在细菌门水平上,厚壁菌门、拟杆菌门、变形菌门丰度较高,胆囊结石患者中变形菌门的含量显著高于健康个体(P<0.05),厚壁菌门、拟杆菌门的含量在两类人群中差异无统计学意义。在细菌属水平上,粪肠球菌、拟杆菌属、普拉梭菌属、毛螺科菌丰度较高,胆囊结石患者中普拉梭菌、毛螺科菌、罗氏菌属的含量胆囊结石患者明显低于健康志愿者(P<0.05)。[结论]肠道菌群失调是机体从胆固醇代谢异常到胆囊胆固醇结石形成过程中的一个影响因素。

[Objective]To investigate the distribution of gut microbiota in asymptomatic patients with gallstones and its clinical ssignificance.[Methods]Fifty-one asymptomatic patients with gallstones admitted to the department of surgery of our hospital from January 2014 to January 2018 were selected as the study subjects,and another 55 healthy volunteers were selected as the control group.The gut microbiota of gallstones and healthy individuals were respectively represented by their fecal flora.The gut microbiota was selectively cultured and quantitatively analyzed by traditional culture methods.The composition and composition of gut microbiota were analyzed according to the high-throughput sequencing results of the microbial community.[Results]The contents of Enterobacter and enterococcus in the feces of patients with gallstones were increased,and the contents of Enterobacter were significantly increased(P<0.05).The content of Bifidobacterium and lactobacillus in patients with gallstone decreased,and the content of lactobacillus decreased significantly(P<0.05).At the level of bacteria,Firmicutes,Bacteroidetes and Proteobacteria were abundant.The content of Proteobacteria in patients with gallstones was significantly higher than that of healthy individuals(P<0.05),and there was no significant difference in the content of Firmicutes and Bacteroidetes between the two groups of people.At the level of bacteria genus,Enterococcus,Bacteroides,Faecalibacterium and Lachnospriacea have high abundance,the content of Faecalibacterium,Lachnospiracea and Roseburia in patients with gallstone is significantly lower than that in healthy individuals(P<0.05).[Conclusion]Gut microbiota disorder is one of the influential factors in the formation of cholesterol stones from abnormal cholesterol metabolism to gallstones.