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肠道微生物群的改变与肠道衰竭相关肝病及中心静脉导管感染有关。

Alterations in intestinal microbiota relate to intestinal failure-associated liver disease and central line infections.

作者信息

Wang Panliang, Wang Ying, Lu Lina, Yan Weihui, Tao Yijing, Zhou Kejun, Jia Jie, Cai Wei

机构信息

Department of Pediatric Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China.

出版信息

J Pediatr Surg. 2017 Aug;52(8):1318-1326. doi: 10.1016/j.jpedsurg.2017.04.020. Epub 2017 May 3.

Abstract

BACKGROUND

The gut microbiota plays a vital role in modulating the metabolic and immune functions of the intestines. We aimed to analyze the dysbiosis of microbiota in infants with short bowel syndrome (SBS) with different complications.

PROCEDURE

We included 26 fecal samples from 18 infants with SBS during parenteral nutrition. The samples were categorized into three groups: asymptomatic, parenteral nutrition-associated liver disease (PNALD), and central line-associated bloodstream infection (CLABSI). Seven healthy infants were enrolled as controls. Fecal microbiota, secretory IgA, calprotectin, bile acids, and short chain fatty acids were detected.

RESULTS

The bacterial diversity of the Asymptomatic and Control Groups was significantly higher than that in the PNALD and CLABSI Groups. Proteobacteria was the most pronounced phylum in the PNALD and CLABSI Groups. Decreased acetate was observed in all SBS samples; however, fecal secretory IgA and calprotectin and the proportion of primary and secondary bile acids did not differ from those in healthy controls.

CONCLUSIONS

Marked alterations of the intestinal microbiota with decreased level of acetate were shown in SBS patients compared with healthy controls. Over-abundance of Proteobacteria (especially Enterobacteriaceae) was found in the samples from the PNALD and CLABSI Groups.

LEVEL OF EVIDENCE

Prognosis Study, Level I.

摘要

背景

肠道微生物群在调节肠道代谢和免疫功能中起重要作用。我们旨在分析患有不同并发症的短肠综合征(SBS)婴儿的微生物群失调情况。

方法

我们纳入了18例接受肠外营养的SBS婴儿的26份粪便样本。样本分为三组:无症状组、肠外营养相关肝病(PNALD)组和中心静脉导管相关血流感染(CLABSI)组。纳入7例健康婴儿作为对照。检测粪便微生物群、分泌型IgA、钙卫蛋白、胆汁酸和短链脂肪酸。

结果

无症状组和对照组的细菌多样性显著高于PNALD组和CLABSI组。变形菌门是PNALD组和CLABSI组中最显著的菌门。在所有SBS样本中均观察到乙酸盐减少;然而,粪便分泌型IgA和钙卫蛋白以及初级和次级胆汁酸的比例与健康对照组无差异。

结论

与健康对照组相比,SBS患者肠道微生物群有明显改变,乙酸盐水平降低。在PNALD组和CLABSI组的样本中发现变形菌门(尤其是肠杆菌科)过度增殖。

证据水平

预后研究,I级。

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