菌群多样性与巴雷特食管患者病理特征的相关性分析

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摘要目的分析巴雷特食管（BE）患者菌群多样性与病理特征的相关性。方法将2016年1月—2019年12月于新疆医科大学第一附属医院消化科诊治的141例BE患者纳入研究（BE组），并选取138名同期正常体检者作为对照组，比较两组食管菌群构成差异。根据BE患者病理检查结果将其分为贲门腺型（53例）、胃底腺型（59例）及特殊肠化生型（29例），比较不同分型患者年龄、性别等一般临床资料及菌群多样性，采用Spearman模型分析患者不典型增生程度与菌群多样性的相关性。结果 BE组链球菌属、梭杆菌属、嗜血杆菌属及葡萄球菌属丰度低于对照组（P ＜ 0.05）；而BE组弯曲杆菌属、韦荣球菌属、巴氏杆菌属、普雷沃菌属及奈瑟菌属丰度高于对照组（P ＜ 0.05）。不同分型患者不典型增生程度比较，差异有统计学意义（P ＜ 0.05）；年龄、性别、柱状上皮长度比较，差异无统计学意义（P ＞ 0.05）。重度组Chao1、Ace及Shannon指数明显高于轻度及中度组，且中度组高于轻度组，差异有统计学意义（P ＜ 0.05）；而重度组Simpson指数明显低于轻度及中度组，且中度组低于轻度组，差异有统计学意义（P ＜ 0.05）。相关分析显示，Chao1、Ace及Shannon指数与患者不典型增生程度呈正相关（r = 0.622、0.593、0.588，P ＜ 0.05），而Simpson指数与患者不典型增生程度呈负相关（r = -0.582，P ＜ 0.01）。结论 BE患者食管菌群发生变化，且菌群多样性与BE患者病理特征具有一定联系，可能与患者预后不良相关。

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	克拉热·阿合买提赫晓磊哈丽达·夏尔甫哈孜张志强高鸿亮

关键词 ：巴雷特食管, 菌群多样性, 病理特征, 相关性分析

Abstract：Objective To analyze the correlation between the bacterial diversity and pathological characteristics of patients with Barrett’s esophagus (BE). Methods A total of 141 BE patients who were diagnosed and treated in the Department of Gastroenterology the First Affiliated Hospital of Xinjiang Medical University from January 2016 to December 2019 were included in the study (BE group), and a total of 138 persons with normal physical examination during the same period were selected as control. The differences in esophageal flora composition between the two groups were compared. According to the pathological examination results of BE, patients were divided into cardia gland type (53 cases), fundus gland type (59 cases) and special intestinal metaplasia type (29 cases). The clinical data such as age and gender, and flora diversity of patients with different types were compared. Spearman model was used to analyze the correlation between patients’ dysplasia and flora diversity. Results The abundances of Streptococcus, Fusobacterium, Haemophilus, and Staphylococcus in the BE group were lower than those in the control group (P < 0.05); while in the BE group, the abundance of Campylobacter, Veronococcus and Pasteurella, the abundance of Bacillus, Prevotella and Neisseria were higher than those of the control group (P ＜ 0.05). Comparison of the degree of dysplasia in patients with different types, and the differences was statistically significant (P ＜ 0.05). There were no statistically significant differences in age, gender and columnar epithelium length of patients with different types (P ＞ 0.05). The Chao1, Ace, and Shannon indexes of severe group were significantly higher than those of mild and moderate group, and the differences were statistically significant (P ＜ 0.05), while those in moderate group were higher than those in mild group (P ＜ 0.05); the Simpson index in severe group was significantly lower than that of mild and moderate group, while moderate group was lower than mild group, and the differences were statistically significant (P ＜ 0.05). Correlation analysis showed that Chao1, Ace and Shannon indexes were positively correlated with the degree of dysplasia in patients (r = 0.622, 0.593, 0.588, P ＜ 0.05), while the Simpson index was negatively correlated with the degree of dysplasia in patients (r = -0.582, P ＜ 0.01). Conclusion The esophageal flora of patients with BE esophagus changes, and the diversity of the flora is related to the pathological characteristics of patients with BE esophagus, which may be related to the poor prognosis of patients.

Key words： Barrett’s esophagus Flora diversity Pathological characteristics Correlation analysis

基金资助:新疆维吾尔自治区自然科学基金项目（2015211 C087）。

通讯作者: 张志强（1976.9-），男，博士，主任医师，硕士生导师；研究方向：消化系疾病及消化道肿瘤的临床与基础研究。

作者简介: 克拉热·阿合买提（1990.8-），女，硕士；研究方向：胃肠道疾病及慢性肝病的诊治。

引用本文:

克拉热·阿合买提赫晓磊哈丽达·夏尔甫哈孜张志强高鸿亮. 菌群多样性与巴雷特食管患者病理特征的相关性分析[J]. 中国医药导报, 2021, 18(4): 24-28.
KALARE·Ahemati HE Xiaolei HALIDA·Xiaerfuhazi ZHANG Zhiqiang GAO Hongliang. Correlation analysis of bacterial diversity and pathological characteristics of patients with Barrett’s esophagus. 中国医药导报, 2021, 18(4): 24-28.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2021/V18/I4/24

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