内镜黏膜切除术患者的肠道微生物群特征及膳食纤维干预
Intestinal microbiota characteristics and dietary fiber intervention in patients undergoing endoscopic mucosa resection.
作者信息
Niu Wen-Cui, Wang Shao-Hua, Zhao Ye
机构信息
Department of Nutrition, Beijing Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 100039, China.
Department of Gastroenterology, Beijing Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 100039, China.
出版信息
World J Gastrointest Surg. 2025 Jul 27;17(7):105893. doi: 10.4240/wjgs.v17.i7.105893.
BACKGROUND
Endoscopic mucosa resection (EMR) is an important minimally invasive surgical method for treating early digestive tract tumors. In recent years, the crucial role of intestinal microbiota in disease occurrence and development has attracted increasing attention. However, the changes in intestinal microbiota after EMR and the effect of dietary fiber intervention on microbiota recovery remain insufficiently elucidated.
AIM
To investigate the effects of dietary fiber intervention on intestinal microbiota recovery in patients undergoing EMR and evaluate its potential to improve postoperative outcomes and intestinal microecological balance.
METHODS
This retrospective study analyzed intestinal microbiota sequencing and dietary fiber intervention in patients with EMR. Patients who underwent EMR surgery between 2020 and 2023 were selected and divided into a routine follow-up group and a dietary fiber intervention group. High-throughput 16S rRNA gene sequencing was performed to detect changes in patient intestinal microbiota, and microbiota diversity, structure, and function in different intervention groups were compared and analyzed.
RESULTS
A total of 86 patients with EMR were included in the study. Results showed that: (1) Intestinal microbiota diversity significantly decreased after EMR surgery, with notable changes in the proportion of Gram-negative bacilli and anaerobic bacteria; (2) The microbiota recovery rate in the dietary fiber intervention group was significantly higher than that in the control group, with a significantly higher microbiota diversity index ( < 0.05); and (3) The abundance of lactobacilli and bifidobacteria in the intervention group increased substantially, and intestinal barrier-related functional gene expression was upregulated.
CONCLUSION
Dietary fiber intervention can effectively promote intestinal microbiota recovery in patients with EMR, improve intestinal microecological balance, and provide a new intervention strategy for clinical post-EMR patient rehabilitation.
背景
内镜黏膜切除术（EMR）是治疗早期消化道肿瘤的一种重要微创手术方法。近年来，肠道微生物群在疾病发生和发展中的关键作用日益受到关注。然而，EMR术后肠道微生物群的变化以及膳食纤维干预对微生物群恢复的影响仍未得到充分阐明。
目的
探讨膳食纤维干预对接受EMR患者肠道微生物群恢复的影响，并评估其改善术后结局和肠道微生态平衡的潜力。
方法
本回顾性研究分析了EMR患者的肠道微生物群测序和膳食纤维干预情况。选取2020年至2023年间接受EMR手术的患者，分为常规随访组和膳食纤维干预组。采用高通量16S rRNA基因测序检测患者肠道微生物群的变化，并比较分析不同干预组的微生物群多样性、结构和功能。
结果
本研究共纳入86例EMR患者。结果显示：（1）EMR术后肠道微生物群多样性显著降低，革兰氏阴性杆菌和厌氧菌比例发生显著变化；（2）膳食纤维干预组的微生物群恢复率显著高于对照组，微生物群多样性指数显著更高（<0.05）；（3）干预组中乳酸杆菌和双歧杆菌的丰度大幅增加，与肠道屏障相关的功能基因表达上调。
结论
膳食纤维干预可有效促进EMR患者肠道微生物群的恢复，改善肠道微生态平衡，为临床EMR术后患者康复提供新的干预策略。
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