肝硬化患者经颈静脉肝内门体分流术前后肠道菌群特征分析

李强; 朱清亮; 张海龙; 邓明明; 胡庆; 王紫洁

doi:10.3969/j.issn.1001-5256.2020.02.020

肝硬化患者经颈静脉肝内门体分流术前后肠道菌群特征分析

DOI: 10.3969/j.issn.1001-5256.2020.02.020

西南医科大学附属医院消化内科

基金项目:

中国肝炎防治基金会—天晴肝病研究基金资助项目(TQGB20190246)；

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中图分类号: R575.2
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出版历程
- 收稿日期: 2019-08-20
- 出版日期: 2020-02-20

Characteristics of intestinal flora before and after transjugular intrahepatic portosystemic shunt in patients with liver cirrhosis

Department of Gastroenterology,The Affiliated Hospital of Southwest Medical University

Research funding:

摘要

摘要:
目的对比分析肝硬化患者经颈静脉肝内门体分流术（TIPS）前后肠道菌群的特征。方法选取2018年7月-2019年7月西南医科大学附属医院消化内科住院行TIPS的肝硬化患者18例,术前采集粪便18例,术后1个月采集粪便6例,术后3个月采集粪便9例,同时收集患者术前及术后肝功能和凝血检验结果。对粪便样本采用16S rRNA高通量测序方法,生物信息分析流程使用QIIME2推荐的DADA2方法,以生成的扩增特征序列（OTU）为单位研究肠道菌群,采用多重假设检验LEfSe、SPSS（Alpha分析）、PERMANOVA（Beta分析）、Pheatmap方法分析肠道菌群。符合正态分布的计量资料不同采集时间点的指标组间比较采用重复测量资料方差分析;不符合正态分布的计量资料各时间点的组间比较采用广义估计方程,进一步两两比较采用Bonferroni法。结果TIPS术前与术后3个时期肝功能指标对比中,TBil和总胆汁酸组间差异均有统计学意义（F值分别为8. 201、39. 482,P值分别为0. 001、<0. 001）。术后1个月粪便样本较术前相比存在Beta多样性变化（F=2. 603,P=0. ...
- 肝硬化 /
- 门体分流术,经颈静脉肝内 /
- 胃肠道微生物组
Abstract:
Objective To investigate the characteristics of flora microbiota before and after transjugular intrahepatic portosystemic shunt( TIPS) in patients with liver cirrhosis. Methods A total of 18 patients with liver cirrhosis who were hospitalized and underwent TIPS in Department of Gastroenterology,The Affiliated Hospital of Southwest Medical University,from July 2018 to July 2019 were enrolled. Fecal samples were collected from 18 patients before surgery,6 fecal samples were collected at 1 month after surgery,and 9 were collected at 3 months after surgery. The results of liver function and coagulation were collected before and after surgery. Fecal samples were analyzed by the 16 S rRNA high-throughput sequencing method,and the DADA2 method recommended by QIIME2 was used in the bioinformatics analysis. The intestinal flora was analyzed in terms of the generated amplified characteristic sequence,and the multiple hypothesis tests of LEfSe,SPSS( Alpha analysis),PERMANOVA( Beta analysis),and Pheatmap were used for analysis. For normally distributed continuous data,intergroup comparison of parameters at different time points was made by a repeated measures analysis of variance. For non-normally distributed continuous data,intergroup comparison of parameters at different time points was made using a generalized estimating equation,and further pairwise comparison was made using the Bonferroni method. Results There were significant differences in total bilirubin and total bile acid between groups before TIPS and during the three periods of time after TIPS( F = 8. 201 and 39. 482,P = 0. 001 and P < 0. 001).At 1 month after surgery,Beta diversity changes were observed in fecal samples( F = 2. 603,P = 0. 02),while there was no significant difference in Alpha diversity of the fecal samples between the three periods of time( P > 0. 05). At the genus level,portal venous pressure before TIPS was negatively correlated with Bifidobacterium,Collinsella,and Ruminococcus( r =-0. 35,-0. 38,and-0. 34,P = 0. 04,0. 02,and 0. 04) and was positively correlated with Boletus( r = 0. 41,P = 0. 015). Other indices were also correlated with different components of the intestinal flora( P < 0. 05). Conclusion There is a correlation between clinical indices and intestinal flora before TIPS. The composition of intestinal flora changes after TIPS,with a significant difference at the genus level.
- liver cirrhosis /
- portasystemic shunt,transjugular intrahepatic /
- gastrointestinal microbiome

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