作者：蓝文通1,2，熊理守2，李秀红1

单位：1.中山大学公共卫生学院 妇幼卫生学系，广东 广州 510080； 2.中山大学附属第一医院 内镜中心，广东 广州 510080

Authors: Lan Wentong1,2，Xiong Lishou2，Li Xiuhong1

Unit: 1.Department of Maternal and Child Health, College of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China； 2.Department of Gastroenterology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080,

Guangdong, China

摘要：

目的 探索影响慢性便秘的优势菌群及其分布特征。方法 选取慢性便秘病例患者和健康对照23例分别纳入便秘组与对照组,内镜下用无菌活检钳分别钳取升结肠和降结肠黏膜各2块(>100 ng),采用16S rDNA测序技术进行检测。结果 对照组前十优势菌群的占比高于便秘组。其中,对照组升结肠与降结肠的菌群分布非常接近,而便秘组中施诺德格拉斯拉氏菌群在降结肠(0.012 936%)中占比高于升结肠(0.000 001%)。对照组升结肠内菌群结构分布最为集中,便秘组升结肠菌群分布最为分散。在菌落组成的组内差异方面,对照组差异较大,便秘组差异较小,且对照组与便秘组菌落组成相似度不高。对照组与便秘组的菌群复杂度在组间及组内均无明显差异。结论 慢性便秘患者肠黏膜菌群丰度下降,且菌群的组成明显不同于健康者,主要表现为变形菌门,肠杆菌的减少,拟杆菌的增加,致病机制可能是肠道菌群失调引起菌群代谢产物(组学)的改变。

关键词：  慢性便秘; 菌群丰度; 肠道菌群; 16S rDNA

Abstract：

Objective To explore the dominant flora and its distribution characteristics affecting chronic constipation. Methods Sequence-specific 16S rDNA detection was employed to detect the difference of intestinal flora between 23 patients with chronic constipation(CC) and 23 health controls(HCs). Ascending and descending colon mucosal tissues were taken and transferred to a -80益refrigerator for preservation. Results The proportion of the top 10 dominant bacteria in the HCs was higher than that in patients with CC. Among them, the flora distribution of ascending colon and descending colon in the HCs was similar, while the Snodgrassella flora was richer in descending colon (0.012 936%) than in ascending colon (0.000 001%)of the patients with CC. The intestinal flora distribution was most concentrated in ascending colon of HCs, while the intestinal flora distribution was most dispersed in in ascending colon of patients with CC. Referred to the bacterial colonies, it was similar in the patients with CCs and very different in HCs. The similarities of the bacterial colonies between the health group and the constipation group were not high. There was no significant difference in the bacterial complexity between the HCs and the patients with CC. Conclusion The abundance of intestinal mucosal flora in patients with CC was decreased, and the composition of intestinal mucosal flora was significantly different from that of HCs. The principal manifestation was reduction of proteobacteria and enterobacteria, and increase of bacteroides. The pathogenic mechanism may be the change of microbial metabolites (omics) caused by intestinal flora imbalance.

Key Words: Chronic constipation; Bacteria abundance; Intestinal flora; 16S rDNA