16S rDNA高通量测序分析腹膜透析胃肠功能障碍患者肠道菌群特征

采用16S rDNA高通量测序技术分析腹膜透析（PD）胃肠功能障碍患者的肠道菌群变化特征，探讨肠道菌群在腹膜透析胃肠功能障碍中的具体作用。

收集25例PD胃肠功能正常者（PDGF组）、25例PD胃肠功能障碍者（PDGD组）和13例健康者（Normal组）的粪便样本，提取肠道菌群基因组，应用16S rDNA高通量测序技术对各组测序结果进行菌群多样性、物种组成差异和菌群功能分析。

3组的Observed species指数（H = 6.905，P = 0.032）和Shannon指数（H = 6.993，P = 0.030）差异具有统计学意义。与Normal组相比，PDGD组Shannon指数显著降低（P = 0.027），PDGF组Observed species指数显著升高（P = 0.044）；与PDGF组相比，PDGD组Observed species和Shannon指数显著降低（P＜0.05）。PCoA结果显示3组各自聚集，区分较明显。UPGMA聚类分析结果显示3组大部分样本均在本组中聚类后再与其他组进一步合并。LEfSe分析结果显示，Normal组优势菌群包括颤螺菌目（Oscillospirales）、瘤胃菌科（Ruminococcaceae）、栖粪杆菌属（Faecalibacterium）、拟杆菌科（Bacteroidaceae）等；PDGF组优势菌群包括毛螺菌目（Lachnospirales）、毛螺菌科（Lachnospiraceae）、布劳特菌属（Blautia）；PDGD组优势菌群包括芽孢杆菌纲（Bacilli）、乳杆菌目（Lactobacillales）、链球菌属（Streptococcus）、链球菌科（Streptococcaceae）等。KEGG L1水平的功能组成集中在代谢、遗传信息处理和环境信息处理；KEGG L2水平的功能主要集中在碳水化合物、氨基酸代谢、遗传信息的复制和修复及转运、膜运输途径；与Normal组和PDGF组相比，PDGD组在碳水化合物、氨基酸代谢途径富集减少，感染性疾病、聚糖生物合成和代谢途径富集增加。

PD胃肠功能障碍患者存在肠道菌群失调，调整肠道微生态是防治PD患者出现胃肠功能障碍的潜在干预靶标。

Characteristics of intestinal flora in patients with peritoneal dialysis-associated gastrointestinal dysfunction based on 16S rDNA high-throughput sequencing

ObjectiveTo analyze the characteristics of gut flora in patients with peritoneal dialysis (PD)-associated gastrointestinal dysfunction (GD) and explore the specific role of gut flora. MethodsStool samples were collected from 25 PD patients with normal gastrointestinal function (PDGF group), 25 PD patients with gastrointestinal dysfunction (PDGD group) and 13 healthy individuals (Normal group), and the intestinal flora genome was extracted. 16S rDNA high-throughput sequencing technology was applied to analyze the flora diversity, species composition and flora function in each group. ResultsThe Observed species (H = 6.905, P = 0.032) and Shannon index (H = 6.993, P = 0.030) in the three groups were significantly different. Compared with the Normal group, the Shannon index in PDGD group significantly decreased (P = 0.027), while the Observed species in PDGF group significantly increased (P = 0.044). Compared with PDGF group, the Observed species and Shannon index in PDGD group significantly decreased (P＜0.05). PCoA analysis showed that the samples in three groups were clustered separately. LEfSe analysis showed that the dominant flora in the Normal group included Oscillospirales, Ruminococcaceae, Faecalibacterium and Bacteroidaceae. The dominant flora in the PDGF group included Lachnospirales, Lachnospiraceae and Blautia, and the dominant flora in the PDGD group included Bacilli, Lactobacillales, Streptococcus and Streptococcaceae. The functional composition at the KEGG L1 focused on metabolism, genetic information processing and environmental information processing, while at the KEGG L2, it focused on carbohydrate and amino acid metabolisms, genetic information replication and repair and translocation, and membrane transport pathways. Compared with Normal and PDGF groups, the PDGD group decreased in carbohydrate and amino acid metabolism pathways and increased in infectious disease, glycan biosynthesis and metabolism pathways. ConclusionPatients with PD-associated gastrointestinal dysfunction have intestinal flora disorders. Intestinal microflora is a potential intervention target for prevention and treatment of gastrointestinal dysfunction in PD patients.