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肠道切除术后肠道菌群和短链脂肪酸的定性变化。

Qualitative changes in enteric flora and short-chain fatty acids after intestinal resection.

作者信息

Thompson J S, Quigley E M, Adrian T E

机构信息

Omaha VAMC, and Department of Surgery, University of Nebraska Medical Center, 68198-3280, USA.

出版信息

Dig Dis Sci. 1998 Mar;43(3):624-31. doi: 10.1023/a:1018831728734.

Abstract

Our aim was to determine the effect of intestinal transection and resection on the prevalence of enteric flora and evaluate whether any such changes alter luminal SCFA and lactic acid content. Dogs underwent either 50% proximal (PR, N = 6) or distal (DR, N = 7) resection, distal resection with bypass of the ileocecal junction (DRBP, N = 9) or midpoint transection alone performed to serve as the appropriate control for luminal sampling for either proximal (PTC, N = 6) or distal (DTC, N = 7) resection. Studies were performed every four weeks for 12 weeks. Both jejunum and ileum had >10(5)/ml aerobic bacteria, most commonly E. coli. Streptococcal species were more common in the normal jejunum than ileum but were found in the ileal remnant after PR. Significant (>10(5)) anaerobic growth occurred infrequently in the jejunum, and DR did not increase anaerobic growth in jejunum unless DRBP was performed (93% vs 62% DR, 45% DTC, 20% normal jejunum, P < 0.05). Clostridium species increased significantly in the jejunal remnant after DRBP. Significant anaerobic growth occurred infrequently in normal ileum but increased after PR (89% vs 50% PTC, P < 0.05). Flora normally found in the jejunum tended to increase in the ileum after PR. Jejunal SCFA increased after DRBP (3126 +/- 577 microg/ml vs 1600 +/- 301 DTC, P < 0.05) but not DR (1791 +/- 321 microg/ml). Significant (>10(5)) anaerobic bacterial growth was associated with increased SCFA content (2717 +/- 381 vs 1029 +/- 170 microg/ml, P < 0.05) and the presence of lactic acid (30% vs 5%, P < 0.05), but there was no correlation between the presence of specific bacteria and SCFA and lactic acid. Following resection of the proximal small intestine, the intestinal remnant tends to assume the bacteriologic characteristics of the resected segment. Following a distal resection, the presence of an intact ICJ protects against the proliferation of a flora characteristic of the distal intestine; resection with bypass of the ICJ results in the appearance of coliforms in the jejunal remnant. These changes in enteric flora do not correlate with content of specific SCFA and lactic acid in the small intestine.

摘要

我们的目的是确定肠横断和切除对肠道菌群流行率的影响,并评估此类变化是否会改变肠腔短链脂肪酸(SCFA)和乳酸含量。犬只接受了50%的近端切除(PR,n = 6)或远端切除(DR,n = 7)、远端切除并绕过回盲部(DRBP,n = 9),或仅进行中点横断作为近端(PTC,n = 6)或远端(DTC,n = 7)切除的肠腔采样的合适对照。研究每四周进行一次,共进行12周。空肠和回肠中需氧菌数量均>10⁵/ml,最常见的是大肠杆菌。链球菌属在正常空肠中比回肠中更常见,但在PR术后的回肠残端中也有发现。空肠中很少出现显著(>10⁵)的厌氧菌生长,除非进行DRBP,否则DR不会增加空肠中的厌氧菌生长(93%对62%的DR、45%的DTC、20%的正常空肠,P<0.05)。DRBP术后空肠残端中的梭菌属显著增加。正常回肠中很少出现显著的厌氧菌生长,但PR术后增加(89%对50%的PTC,P<0.05)。PR术后,通常在空肠中发现的菌群在回肠中有增加的趋势。DRBP术后空肠SCFA增加(3126±577μg/ml对1600±301μg/ml的DTC,P<0.05),但DR术后未增加(1791±321μg/ml)。显著(>10⁵)的厌氧菌生长与SCFA含量增加(2717±381对1029±170μg/ml,P<0.05)和乳酸的存在(30%对5%,P<0.05)相关,但特定细菌的存在与SCFA和乳酸之间没有相关性。近端小肠切除后,肠残端往往呈现被切除段的细菌学特征。远端切除后,完整的回盲部可防止远端肠道特征性菌群的增殖;绕过回盲部进行切除会导致空肠残端出现大肠菌属。肠道菌群的这些变化与小肠中特定SCFA和乳酸的含量无关。

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