单倍型造血干细胞移植后疾病复发患者肠道微生态改变的临床分析

Clinical analysis of intestinal microecological changes in patients with disease relapse after haplotype hematopoietic stem cell transplantation

目的探索单倍型移植体系中肠道微生态与移植后疾病复发的相关性。方法对单倍型造血干细胞移植后疾病复发的19例患者(复发组)和同期移植未复发的19例患者(对照组)进行回顾性分析,采用扩增子测序法和宏基因组检测法分析两组之间的肠道微生态的差异。结果与对照组相比,复发组中Alpha多样性指数趋于上升,肠道中有害菌数量增多。宏基因组分析显示在属和种2个水平中,复发组微生物种类较对照组明显增加。生物信息学分析显示,复发组营养代谢通路及相关因子失衡。结论单倍型造血干细胞移植后疾病复发患者的肠道微生态存在紊乱,倾向于有害菌增加及其营养代谢通路失衡。

Objective To explore the correlation between the intestinal microecology and disease relapse after transplantation in haplotype transplant system.Methods Nineteen patients with disease relapse after haplotype hematopoietic stem cell transplantation(relapse group) and 19 patients without disease relapse in contemporaneous transplantation(control group) were retrospectively analyzed.The amplicon sequencing and metagenomic detection methods were used to analyze the differences in the intestinal tract microecology between the two groups.Results Compared with the control group, the Alpha diversity index in the relapse group tended to increase and the number of harmful microbiota in the intestinal tract was increased.The metagenomic analysis showed that the microbial species at both genus and species levels in the relapse group were increased significantly.The bioinformatics analysis showed the imbalance of nutrient metabolic pathway and related factors in the relapse group.Conclusion The intestinal microbiota of the patients with disease relapse after haplotype hematopoietic stem cell transplantation has the disturbance, which tends to increase of harmful bacteria and imbalance of nutrient metabolic pathway.