反流性食管炎患者口腔菌群变化及其与幽门螺杆菌感染的关系

探讨反流性食管炎（RE）患者口腔菌群变化及其与幽门螺杆菌（H. pylori）感染的关系，为该类患者的治疗提供参考。

选择南京同仁医院2019年5月至2021年5月收治的140例RE患者为研究对象，将A、B级RE患者纳入AB组，C、D级纳入CD组；同时将患者分为合并H. pylori感染组和未合并H. pylori感染组。以一次性无菌收集管收集患者唾液标本，使用Illumina Hiseq 2500高通量测序平台对合格文库进行双端测序。

AB组患者H. pylori阳性率（16.67%）低于CD组（45.45%）。AB组患者口腔菌群Chao 1指数和Shannon指数均高于CD组，Simpson指数低于CD组（均P＜0.05）。未合并H. pylori感染组患者口腔菌群Chao 1指数和Simpson指数高于合并H. pylori感染组，Shannon指数低于合并H. pylori感染组（均P＜0.05）。未合并H. pylori感染组患者口腔放线菌门、放线菌属相对丰度高于合并H. pylori感染组，拟杆菌门相对丰度低于合并H. pylori感染组（均P＜0.05）。

RE病情较重者和合并H. pylori感染者表现为口腔菌群α多样性降低和门、属水平菌群相对丰度改变，合并H. pylori感染对RE患者病情和口腔菌群会产生一定影响。

Changes of oral flora in patients with reflux esophagitis and its relationship with Helicobacter pylori infection

Objective To observe the changes of oral microecology in patients with reflux esophagitis (RE) and its relationship with Helicobacter pylori (H. pylori) infection. Methods A total of 140 RE patients admitted to Nanjing Tongren Hospital from May 2019 to May 2021 were selected as the subjects. The RE patients with grades A and B were included in the AB group, while those with grades C and D were included in the CD group. Upon recombination, the patients were divided into H. pylori infection group and non-H. pylori infection group. Saliva samples were collected in disposable sterile collection tubes. Eligible libraries were paired-end sequenced using the Illumina Hiseq 2500 high-throughput sequencing platform. Results The positive rate of H. pylori in AB group was lower than that in CD group (16.67% vs 45.45%). The oral flora Chao 1 index and Shannon index in the AB group were higher, while the Simpson index was lower than in the CD group, respectively (all P＜0.05). The oral flora Chao 1 index and Simpson index in non-H. pylori group were higher, while the Shannon index was lower than in H. pylori infection group, respectively. The relative abundances of Actinobacteria and Actinomyces in non-H. pylori group were higher, while that of Bacteroidetes was lower than in the H. pylori infection group respectively (all P＜0.05). Conlclusion Severe RE patients and patients with H. pylori infection showed a decrease in the α diversity of oral colonies and changes in the relative abundance at phylum and genus levels. Concommitant H. pylori infection had a certain impact on RE disease and oral microecological communities.