摘要
目的:分析结直肠恶性肿瘤患者术后胃肠道微生物环境临床特点以及与预后的相关性。方法:选取自贡市精神卫生中心2015年1月—2021年1月之间收治的结直肠癌患者90例设为观察组,另外选择接受健康体检的60例为对照组。收集两组粪便标本,并对粪便中益生菌含量以及条件致病菌的种类进行分析;测定患者外周血淋巴细胞亚群的比例,以评价患者免疫功能;使用Kaplan-Meier法绘制患者生存曲线,并对患者的预后进行分析。结果:结直肠恶性肿瘤患者胃肠道中乳酸杆菌、双歧杆菌活菌数量降低,而大肠杆菌的活菌数量升高;部分结直肠癌患者术后可检测出条件致病菌,致病大肠杆菌、铜绿假单胞菌、阴沟肠杆菌等胃肠道常见致病菌的比例较高;检出革兰氏阳性菌患者外周血淋巴细胞所占比例降低,且生存时间缩短。未检出条件致病菌、检出革兰氏阳性菌、检出革兰氏阴性菌以及同时存在革兰氏阳性菌和革兰氏阴性菌患者的中位生存时间分别为55.2(95%CI 54.0~66.5)个月、53.8(95%CI 45.4~62.1)个月、49.1(95%CI 47.8~52.5)个月以及47.7(95%CI 47.4~56.7)个月,其中未检出条件致病菌及检出革兰氏阳性菌未发现条件致病菌组(Control组)与检出革兰氏阳性菌患者组(Gram Pos组)的中位生存时间对比,差异无统计学意义(P>0.05),而检出革兰氏阴性菌的两组生存时间明显减少。结论:结直肠恶性肿瘤术后患者胃肠道菌群发生改变,主要表现为有益菌含量减少以及出现条件致病菌等,检出革兰氏阴性条件致病菌提示患者预后较差,这可能与患者免疫功能降低有关。
Objective To investigate the clinical characteristics of postoperative gastrointestinal microbial environment in patients with colorectal malignant tumor and its correlation with patients’prognosis.Methods 90 colorectal cancer patients admitted to the Zigong Mental Health Center from January 2015 to January 2021 were selected as the observation group,and 60 normal subjects who underwent physical examinations were selected as the control group.The fecal specimens of the subjects were collected,the probiotics content and the types of pathogenic bacteria in the feces of the subjects were analyzed.The proportion of peripheral blood lymphocyte subsets in the patients was also measured to evaluate the immune function of the patients;Kaplan-Meier method was used to generate patients’survival curves,and log-rank test was employed to investigate the statistical significance.Results The number of live bacteria of lactobacilli and bifidobacteria was decreased,while the number of live bacteria of Escherichia coli was increased in the gastrointestinal tract of patients with colorectal malignant tumors.Conditional pathogens and pathogenic Escherichia coli was detected in some patients with colorectal cancer.The proportion of common pathogenic bacteria in the gastrointestinal tract such as Pseudomonas aeruginosa and Enterobacter cloacae constitute the major population in conditional pathogenic bacteria.In addition,the proportion of peripheral blood lymphocytes in patients with Gram-positive bacteria was decreased.Survival analysis showed survival time was shortened in patience which detected Gram-negative bacteria.The median survival time of patience without conditional pathogenic bacteria,with Gram-positive bacteria,with Gram-negative bacteria,and with Gram-positive plus Gram-negative bacteria were 55.2(95%CI 54.0~66.5)months,53.8(95%CI 45.4~62.1)months,49.1(95%CI 47.8~52.5)months and 47.7(95%CI 47.4~56.7)months,respectively.The median survival time of the Control group and the Gram Pos group was similar,but the survival time of the Gram negative group was significantly reduced.Conclusion The gastrointestinal flora of patients with colorectal malignant tumors was differed from healthy volunteer,characterized by reduced beneficial bacteria content and the emergence of conditional pathogens.Detection of Gram-negative pathogens suggested poor prognosis,which may be related to impaired immune function in patients.
作者
潘丽娟
蒋文捷
PAN Lijuan;JIANG Wenjie(Department of Sensory,Zigong Mental Health Center,Zigong,Sichuan 643000,China;Department of Elderly,Zigong Mental Health Center,Zigong,Sichuan 643000,China)
出处
《医药前沿》
2023年第8期1-6,10,共7页
Journal of Frontiers of Medicine
关键词
结直肠肿瘤患者
术后
肠道菌群
免疫功能
预后
Colorectal cancer patients
Postoperative
Intestinal flora
Immune function
Prognosis
