摘要
目的分析肝硬化门脉高压症患者胃菌群的结构特征、影响因素及其与临床参数间的相关性。方法收集2020年11月至2021年11月于陆军特色医学中心消化内科住院接受经颈静脉肝内门体分流术(transjugular intrahepatic portosystemic shunt,TIPS)治疗的肝硬化患者的术前胃黏膜与胃液标本,并采集住院期间相关临床参数。采用16S rRNA分析胃菌群的构成及多样性,运用LEfSe寻找差异菌,冗余分析(redundancy analysis,RDA)识别胃微生物群落结构变化的主要影响因素,Spearman相关分析探讨菌群丰度与临床参数间的相关性。结果变形菌门(Proteobacteria)、放线菌门(Actinobacteria)、酸杆菌门(Acidobacteria)、绿弯菌门(Chloroflexi)等在胃黏膜中富集,而厚壁菌门(Firmicutes)、梭菌门(Fusobacteria)在胃液中富集。肝硬化门脉高压症患者胃黏膜物种Chao1指数显著高于胃液(P<0.01),两者间Shannon指数差异无统计学意义(P>0.05)。PCoA分析表明,胃黏膜与胃液间群落构成差异有统计学意义(P<0.05)。对肝硬化门脉高压性胃病(portal hypertensive gastropathy,PHG)患者胃菌群分析显示,消化链球菌属(Peptostreptococcus)、二氧化碳噬纤维菌属(Capnocytophaga)在PHG患者胃黏膜中富集。肝硬化PHG与non-PHG患者间胃黏膜菌群α多样性与β多样性差异均无统计学意义(P>0.05)。RDA分析表明,门静脉压力梯度(portal pressure gradient,PPG)是影响患者胃黏膜菌群结构变化的主要因素(r^(2)=0.683,P<0.001)。哈马达菌属(Hamadaea)、艾肯氏菌属(Eikenella)丰度与PPG呈正相关性(r分别为0.633、0.618;P<0.05)。结论肝硬化门脉高压症患者胃黏膜与胃液菌群结构存在差异,但两者间物种多样性无差异;肝硬化PHG患者胃黏膜菌群构成有特征性改变。PPG是影响胃黏膜菌群结构变化的主要因素,而胃黏膜哈马达菌属及艾肯氏菌属相对丰度的升高可能与肝硬化门静脉高压相关。
Objective To investigate the structure characteristics,influencing factors and the correlation with clinical parameters of gastric microbiota in cirrhotic patients with portal hypertension.Methods Preoperative gastric mucosa and gastric juice samples were collected from cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt(TIPS)in our hospital from November 2020 to November 2021,and relevant clinical parameters during hospitalization were also obtained.The composition and diversity of gastric microbiota in the patients were analyzed by 16 S rRNA high-throughput sequencing.LEfSe analysis was used to search for different bacteria;Redundancy analysis(RDA)was performed to identify the main factors affecting the gastric microbiota community structure;and Spearman correlation analysis was adopted to explore the correlation between the abundance of gastric microflora and clinical parameters.Results Proteobacteria,Actinobacteria,Acidobacteria and Chloroflexi were enriched in gastric mucosa,while Firmicutes and Fusobacteria in gastric juice.The Chao1 index of species in gastric mucosa was significantly higher than that in gastric fluid(P<0.01),however,the Shannon index of community between the 2 groups was not different(P>0.05).PCoA analysis showed that there was statistical difference in community composition between gastric mucosa and gastric juice(P<0.05).Further analysis of the gastric microbiota indicated that Peptostreptococcus and Capnocytophaga were abundant in the gastric mucosa of patients with portal hypertensive gastropathy(PHG),but theαdiversity andβdiversity of gastric mucosal flora had no significance between PHG and non-PHG patients(P>0.05).RDA analysis suggested that portal pressure gradient(PPG)was the main factor affecting the community structure of gastric mucosa flora(r^(2)=0.683,P<0.001),and the abundance of Hamadaea and Eikenella were positively correlated with PPG(r=0.633,0.618,respectively;P<0.05).Conclusion The microflora structure between gastric mucosa and gastric juice is different in cirrhotic patients with portal hypertension,but there is no significant difference in the species diversity.The composition of gastric mucosal flora in patients with PHG has characteristic changes,and PPG plays an important role in the structure of gastric mucosa microbiota.The relatively increased abundance of Hamadaea and Eikenella in gastric mucosa may be associated with portal hypertension in cirrhosis.
作者
慕之勇
周银斌
肖潇
王军
文良志
陈东风
MU Zhiyong;ZHOU Yinbin;XIAO Xiao;WANG Jun;WEN Liangzhi;CHEN Dongfeng(Department of Gastroenterology,Army Medical Center of PLA,Chongqing,400042,China)
出处
《陆军军医大学学报》
CAS
CSCD
北大核心
2022年第15期1576-1585,共10页
Journal of Army Medical University
基金
国家自然科学基金青年科学基金(81802459)
重庆市自然科学基金基础研究与前沿探索项目(cstc2018jcyjAX0603)
陆军军医大学科技创新能力提升专项项目(2019XLC3045)
关键词
肝硬化
门脉高压
门脉高压性胃病
胃菌群
16s
rRNA
liver cirrhosis
portal hypertension
portal hypertensive gastropathy
gastric microbiota
16s rRNA
作者简介
通信作者:陈东风,E-mail:chendf1981@126.com
