肺结核患者抗结核治疗前后呼吸道菌群生态的变化

Ecological changes of respiratory tract microbial flora in patients with pulmonary tubercu-losis before and after anti-tuberculosis treatment

目的探讨初治敏感肺结核患者经强化期抗结核治疗后呼吸道菌群的变化。方法纳入住院确诊的初治敏感肺结核患者共18例,在抗结核治疗前、治疗8周采集痰液进行16S rRNA测序,对检测出的菌群进行多样性分析及关键物种差异比较,分析菌群变化与临床治疗效果的关系。结果临床疗效评价:显效55.56%(10/18),有效44.44%(8/18),临床治疗总有效率100%。梭杆菌门、螺旋体门、梭杆菌属的相对丰度高于治疗前,放线菌门、链球菌属的相对丰度低于治疗前,差异有统计学意义(P<0.05)。结论初治敏感肺结核患者经强化期抗结核治疗后好转,呼吸道菌群结构改变,梭杆菌门、螺旋体门、梭杆菌属的相对丰度升高,放线菌门、链球菌属的相对丰度降低,可成为评估抗结核疗效的潜在生物标志物。

Objective To investigate the alteration of pulmonary microecology in newly treated patients with sensitive pulmonary tuberculosis after intensive anti-tuberculosis therapy.Methods 18 newly diagnosed sensitive pulmonary tuberculosis patients were included.Sputum samples were collected for 16S rRNA sequencing before and 8 weeks after the anti-tuberculosis treatment.The diversity of the detected pulmonary microecology was analyzed and the differences of key species were compared to analyze the relationship between microecology alteration and clinical treatment effects.Results Clinical efficacy evaluation:markedly effective 55.56%(10/18),effective 44.44%(8/18),and the total effective rate of clinical treatment was 100%.After the intensive anti-tuberculosis treatment,the relative abundances of Fusobacterium,Treponema,and Fusobacterium were higher than those before treatment,and the relative abundances of Actinobacteria and Streptococcus were lower than those before treatment,and the differences were statistically significant(P<0.05).Conclusion When sensitive pulmonary tuberculosis patients improved after the intensive anti-tuberculosis treatment,the change of microbial flora may provide the potential biomarkers for the evaluation of anti-tuberculosis efficacy.