中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2014年
2期
104-107
,共4页
翟慧勤%范红%耿嘉蔚%陶健%寻琳婷%王芸
翟慧勤%範紅%耿嘉蔚%陶健%尋琳婷%王蕓
적혜근%범홍%경가위%도건%심림정%왕예
肝性脑病%肝硬化%内毒素类%肠道微生物
肝性腦病%肝硬化%內毒素類%腸道微生物
간성뇌병%간경화%내독소류%장도미생물
Hepatic encephalopathy%Liver cirrhosis%Endotoxins%Gut flora
目的 探讨轻微型肝性脑病(MHE)患者肠道微生物失调以及血浆内毒素水平的变化.方法 对65例乙型肝炎肝硬化患者行数字连接试验(NCT)-A和数字符号试验(DST)两项检查,筛选出MHE患者26例,另选肝硬化非MHE患者25例和与MHE相匹配的直系健康家属作为对照组.收集受试者的粪便,提取粪便内菌群的16SrDNA,通过PCR技术和新型的二代测序技术——454焦磷酸测序技术对细菌16SrDNA进行检测,得到16SrRNA序列.同步收集受试者的血液,采用鲎试剂比浊法对受试者血液进行内毒素检测.对测序结果采用生物信息学分析和对数据进行单因素方差分析.结果 MHE组患者肠道微生物群的丰度和物种数较健康对照组和肝硬化组降低.健康组的肠道微生物群的多态性较为丰富,而MHE患者的肠道微生物群的多态性较为集中.MHE组的肠道微生物群多态性较肝硬化组单一.肝硬化组与健康对照组相比,有共同的肠道菌群组成成分,同时也具有其独特的肠道菌群成分.与肝硬化组和健康对照组相比,MHE组的拟杆菌门微生物的含量明显降低(P＜0.05)；血浆内毒素水平也较肝硬化组和健康对照组高[分别为(58.13±15.18)pg/ml、(21.32±11.12) pg/ml、(3.16±0.20) pg/ml,F=18.74,P＜0.05].结论 MHE患者肠道菌群存在不同程度的紊乱且伴有血浆内毒素水平升高.
目的 探討輕微型肝性腦病(MHE)患者腸道微生物失調以及血漿內毒素水平的變化.方法 對65例乙型肝炎肝硬化患者行數字連接試驗(NCT)-A和數字符號試驗(DST)兩項檢查,篩選齣MHE患者26例,另選肝硬化非MHE患者25例和與MHE相匹配的直繫健康傢屬作為對照組.收集受試者的糞便,提取糞便內菌群的16SrDNA,通過PCR技術和新型的二代測序技術——454焦燐痠測序技術對細菌16SrDNA進行檢測,得到16SrRNA序列.同步收集受試者的血液,採用鱟試劑比濁法對受試者血液進行內毒素檢測.對測序結果採用生物信息學分析和對數據進行單因素方差分析.結果 MHE組患者腸道微生物群的豐度和物種數較健康對照組和肝硬化組降低.健康組的腸道微生物群的多態性較為豐富,而MHE患者的腸道微生物群的多態性較為集中.MHE組的腸道微生物群多態性較肝硬化組單一.肝硬化組與健康對照組相比,有共同的腸道菌群組成成分,同時也具有其獨特的腸道菌群成分.與肝硬化組和健康對照組相比,MHE組的擬桿菌門微生物的含量明顯降低(P＜0.05)；血漿內毒素水平也較肝硬化組和健康對照組高[分彆為(58.13±15.18)pg/ml、(21.32±11.12) pg/ml、(3.16±0.20) pg/ml,F=18.74,P＜0.05].結論 MHE患者腸道菌群存在不同程度的紊亂且伴有血漿內毒素水平升高.
목적 탐토경미형간성뇌병(MHE)환자장도미생물실조이급혈장내독소수평적변화.방법 대65례을형간염간경화환자행수자련접시험(NCT)-A화수자부호시험(DST)량항검사,사선출MHE환자26례,령선간경화비MHE환자25례화여MHE상필배적직계건강가속작위대조조.수집수시자적분편,제취분편내균군적16SrDNA,통과PCR기술화신형적이대측서기술——454초린산측서기술대세균16SrDNA진행검측,득도16SrRNA서렬.동보수집수시자적혈액,채용후시제비탁법대수시자혈액진행내독소검측.대측서결과채용생물신식학분석화대수거진행단인소방차분석.결과 MHE조환자장도미생물군적봉도화물충수교건강대조조화간경화조강저.건강조적장도미생물군적다태성교위봉부,이MHE환자적장도미생물군적다태성교위집중.MHE조적장도미생물군다태성교간경화조단일.간경화조여건강대조조상비,유공동적장도균군조성성분,동시야구유기독특적장도균군성분.여간경화조화건강대조조상비,MHE조적의간균문미생물적함량명현강저(P＜0.05)；혈장내독소수평야교간경화조화건강대조조고[분별위(58.13±15.18)pg/ml、(21.32±11.12) pg/ml、(3.16±0.20) pg/ml,F=18.74,P＜0.05].결론 MHE환자장도균군존재불동정도적문란차반유혈장내독소수평승고.
Objective To investigate the relationship of gut flora and gut-derived endotoxin with minimal hepatic encephalopathy (MHE).Methods Patients with hepatitis B virus-related liver cirrhosis (HBV-LC) were screened for MHE using the number connect test-A (NCT-A) and digital symbol test (DST) and divided into the following groups:HBV-LC with (+) MHE (n =26) and HBV-liver cirrhosis without (-)MHE (n =25); in addition,one healthy immediate family member of each patient in the HBV-LC + MHE group was enrolled as a control.Each participant provided fecal and blood samples.PCR amplification and 454 pyrosequencing were used to detect bacterial 16S rRNA in feces.Turbidimetric Limulus amebocyte lysate assay was used to detect level of endotoxin in serum.The significance of inter-group differences was assessed by one-way ANOVA or Student's t-test.Results The three groups showed different distributions of gut flora.The differences in the microbial communities' members and distributions were related to disease or health status,but not to the patient's genetic makeup or diet.In particular,the HBV-LC + MHE patients showed significantly lower amounts of different bacterial species and abundance of these species than the other two (non-MHE) groups (P ＜ 0.05).The healthy control family members had a richer diversity of gut flora than their counterparts with HBV-LC + MHE (P ＜ 0.05).The HBV-LV + MHE patients also had higher serum levels of endotoxin.Conclusion Development of minimal hepatic encephalopathy in patients with HBV-LC may be related to a gut flora disorder or higher levels of endotoxin in serum.
