急性胃肠功能损伤患者肠道菌群及其代谢产物的分析

分析重症患者合并急性胃肠功能损伤（AGI）的肠道菌群变化的特征。

采用观察性研究方法，选择2021年1月至2022年12月本院重症监护病房收治的患者36例，根据是否发生AGI分为AGI组（n = 18）和non-AGI组（n = 18），记录入科时患者急性生理与慢性健康状况评分Ⅱ和序贯器官衰竭评估评分，测定患者入科时超敏C反应蛋白、降钙素原以及第1次粪便样本的乙酸、丙酸、丁酸的水平，通过16S rDNA测序分析粪便样本的菌群多样性，比较两组患者肠道菌群差异。

AGI组患者肠道乙酸、丙酸、丁酸水平较non-AGI组显著降低，差异均有统计学意义（均P＜0.05）。AGI组患者肠道菌群alpha多样性显著低于non-AGI组。在细菌门分类水平上，两组患者肠道菌群差异无统计学意义；属水平比较，AGI组患者肠道菌群中肠球菌属、埃希—志贺菌属的相对丰度显著高于non-AGI组（均P＜0.05），non-AGI组中双歧杆菌属相对丰度显著升高（P＜0.05）。

合并AGI重症患者肠道代谢功能失衡，菌群结构发生改变，为益生菌辅助治疗重症患者提供一定临床研究依据。

Intestinal flora and its metabolites in patients with acute gastrointestinal functional injury

ObjectiveTo analyze the characteristics of intestinal flora changes in critically ill patients with acute gastrointestinal injury (AGI). MethodsObservational study method was used. A total of 36 patients who admitted to the intensive care unit of our hospital from January 2019 to June 2022 were divided into AGI group (n = 18) and non-AGI group (n = 18) according to whether AGI occurred. Acute physiology and chronic health status score Ⅱ and sequential organ failure assessment were recorded at admission. The contents of hypersensitive C-reactive protein, procalcitonin and acetic acid, propionic acid and butyric acid in the first fecal sample were determined. The bacterial diversity of fecal sample was analyzed with 16S rDNA sequencing, and compared between the two groups. ResultsCompared with non-AGI group, the contents of acetic acid, propionic acid and butyric acid in AGI group significantly decreased (all P＜0.05). The α-diversity of bacteria in AGI group was significantly lower than that in non-AGI group. There was no significant difference between the two groups in the classification of bacteria. The relative abundances of Enterococcus and Escherichia-Shigella in AGI group were significantly higher than in non-AGI group (all P＜0.05), while that of Bifidobacterium in non-AGI group was significantly higher (P＜0.05). ConclusionThe intestinal metabolism is unbalanced and microflora structure is changed in severe AGI patients, which provides certain clinical basis for probiotics adjuvant therapy in severe patients.