睡眠障碍与非睡眠障碍维持性血液透析患者肠道菌群多样性分析

Analysis of intestinal flora diversity in maintenance hemodialysis patients with sleep disorders versus non-sleep disorders

目的 分析睡眠障碍维持性血液透析(MHD)患者和非睡眠障碍MHD患者肠道菌群结构的差异,探讨MHD患者睡眠障碍与肠道菌群的关系。方法 选取2022年1至7月就诊于温州市中心医院根据匹兹堡睡眠质量指数量表评估为睡眠障碍和非睡眠障碍的MHD患者各30例。采集两组患者粪便标本,进行16S r DNA高通量测序及生物学信息分析,比较两组患者肠道菌群的差异。结果 睡眠障碍组患者肠道菌群的α多样性高于非睡眠障碍组患者(P<0.05)。经β多样性比较,两组患者肠道菌群的菌群结构差异有统计学意义(P<0.05)。进一步行LEfSe分析,相较于非睡眠障碍组患者,睡眠障碍组患者肠道菌群中拟杆菌属、大肠杆菌-志贺氏菌属、毛螺菌属、链球菌属、副拟杆菌属、巴恩斯氏菌属及颤杆菌克属的相对丰度显著升高(均P<0.05),而双歧杆菌属、乳杆菌属及罗氏菌属的相对丰度显著降低(均P<0.05)。结论 睡眠障碍MHD患者和非睡眠障碍MHD患者在肠道菌群结构上存在显著差异。肠道菌群结构的变化可能在MHD患者睡眠障碍的发生、发展中起重要作用。

Objective To explore the relationship between sleep disorders and intestinal flora in maintenance hemodialysis(MHD) patients by analyzing the difference in intestinal flora structure between MHD patients with sleep disorders and without sleep disorders.Methods MHD patients who were treated in the hemodialysis center of our hospital from January 2022 to July 2022 were selected.They were divided into sleep disorder group and non-sleep disorder group according to the Pittsburgh Sleep Quality Index,with 30 patients in each group.The fecal samples of the two groups of patients were collected for 16S rDNA high-throughput sequencing and biological information analysis,and the differences of intestinal flora between the two groups of patients were compared.Results The Alpha diversity of intestinal flora in sleep disorder group was higher than that of non-sleep disorder group(P<0.05).Through Beta diversity comparison,there was statistical significance in intestinal flora structure between the two groups(P<0.05).Further linear discriminant analysis effect size(LEfSe) analysis showed that compared with non-sleep disorder group,the relative abundance of Bacteroides,Escherichia-Shigella,Lachnospira,Streptococcus,Parabacteroides,Barnesiella and Oribacterium in the intestinal flora of MHD patients with sleep disorders were significantly increased(all P<0.05);while the relative abundance of Bifidobacterium,Lactobacillus,and Roseburia were significantly decreased(all P<0.05).Conclusion There were significant differences in intestinal flora structure between MHD patients with sleep disorders and those without sleep disorders.The changes of intestinal flora structure may play an important role in the occurrence and development of sleep disorders of MHD patients.