Zhang Qi-Liang, Zhou Si-Jia, Chen Xiu-Hua, Chen Qiang
Department of Cardiac Surgery, Fujian Medical University (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
Department of Cardiac Surgery, Fujian Medical University (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
Curr Probl Cardiol. 2024 Jan;49(1 Pt B):102111. doi: 10.1016/j.cpcardiol.2023.102111. Epub 2023 Sep 26.
This study aimed to investigate the changes in intestinal flora in infants with ventricular septal defect (VSD) after cardiopulmonary bypass (CPB) surgery and their potential relationship with postoperative gastrointestinal function recovery. Fecal samples of 20 infants with VSD were collected before and after CPB surgery at our hospital from September 2021 to March 2022. 16S rRNA was used to detect and analyze the fecal samples. The most abundant intestinal microbes in the preoperative intestinal flora were Enterococcus (37.14%), Bifidobacterium (20.71%), Shigella (8.15%), Streptococcus (5.19%), Lactobacillus (3.7%), Rothia (2.22%). However, the most abundant intestinal microbes in the postoperative intestinal flora were Enterococcus (49.63%), Bifidobacterium (12.59%), Shigella (10.37%), Streptococcus (8.14%), Rothia (4.43%). The diversity and species richness of intestinal flora after CPB surgery were significantly lower than those preoperatively. The intestinal Enterococcus content in patients with postoperative gastrointestinal dysfunction was significantly higher than that in patients without gastrointestinal dysfunction (P < 0.05). Intestinal Bifidobacterium content in patients with postoperative gastrointestinal dysfunction was significantly lower than that in patients without gastrointestinal dysfunction (P < 0.05). After surgery, the content of intestinal Enterococcus was negatively correlated with the full feeding time, and the content of intestinal Bifidobacterium was positively correlated with full feeding time. After CPB surgery, the diversity and richness of intestinal flora decreased, intestinal pathogenic bacteria increased, and beneficial intestinal bacteria decreased. An increase in Enterococcus and decrease in Bifidobacterium can increase the incidence of gastrointestinal dysfunction and prolong the recovery time of gastrointestinal function.
本研究旨在探讨室间隔缺损（VSD）婴儿体外循环（CPB）手术后肠道菌群的变化及其与术后胃肠功能恢复的潜在关系。2021年9月至2022年3月，我院收集了20例VSD婴儿CPB手术前后的粪便样本。采用16S rRNA对粪便样本进行检测和分析。术前肠道菌群中最丰富的肠道微生物是肠球菌（37.14%）、双歧杆菌（20.71%）、志贺菌（8.15%）、链球菌（5.19%）、乳酸杆菌（3.7%）、罗氏菌（2.22%）。然而，术后肠道菌群中最丰富的肠道微生物是肠球菌（49.63%）、双歧杆菌（12.59%）、志贺菌（10.37%）、链球菌（8.14%）、罗氏菌（4.43%）。CPB手术后肠道菌群的多样性和物种丰富度显著低于术前。术后胃肠功能障碍患者的肠道肠球菌含量显著高于无胃肠功能障碍患者（P<0.05）。术后胃肠功能障碍患者的肠道双歧杆菌含量显著低于无胃肠功能障碍患者（P<0.05）。术后，肠道肠球菌含量与完全喂养时间呈负相关，肠道双歧杆菌含量与完全喂养时间呈正相关。CPB手术后，肠道菌群的多样性和丰富度降低，肠道病原菌增加，有益肠道细菌减少。肠球菌增加和双歧杆菌减少会增加胃肠功能障碍的发生率，并延长胃肠功能的恢复时间。
