肠道菌群特征与食管癌患者术后肺部感染的关系

探究食管癌患者术前肠道菌群特征与术后肺部感染的关系，为该类患者的治疗提供参考。

纳入我院2019年6月至2021年12月期间收治的272例食管癌手术患者为研究对象，根据术后是否并发肺部感染将其分为感染组（64例）和非感染组（208例），记录患者年龄、高血压、吸烟史等一般资料。采用选择性培养基培养患者肠道大肠埃希菌、肠球菌属、葡萄球菌属、双歧杆菌属、酵母菌属、乳杆菌属、消化球菌属细菌并按照平板计数法计数，同时进行16S rRNA基因测序，进行菌群多样性分析。采用Logistic回归进行食管癌患者术后肺部感染的影响因素分析。

感染组与非感染组患者肠道菌群Chaol指数、Shannon指数、Simpson指数比较差异均无统计学意义（均P＞0.05）。与非感染组比较，感染组患者年龄≥60岁、吸烟史≥20年、术前FEV1/FVC＜70%、手术时间≥4 h患者比例及肠道大肠埃希菌、肠球菌属、葡萄球菌属数量显著升高，而肠道双歧杆菌属、酵母菌属、乳杆菌属、消化球菌属数量显著降低（均P＜0.05）。大肠埃希菌、肠球菌属是影响食管癌患者术后发生肺部感染的独立危险因素，而双歧杆菌属是影响食管癌患者术后发生肺部感染的保护因素（均P＜0.05）。

食管癌术后肺部感染患者与未发生肺部感染的其术前肠道菌群差异显著，大肠埃希菌、肠球菌属、双歧杆菌属是食管癌患者术后发生肺部感染的影响因素。

The relationship between intestinal flora and postoperative pulmonary infection in patients with esophageal cancer

ObjectiveTo explore the relationship between preoperative intestinal flora characteristics and postoperative pulmonary infection in patients with esophageal cancer, providing a reference for the treatment. MethodsA total of 272 patients with esophageal cancer who received diagnosis and surgery treatment in our hospital from June 2019 to December 2021 were included as the subjects. They were grouped into infection group of 64 cases and non-infection group of 208 cases according to whether postoperative pulmonary infection was complicated. The baseline data such as age, hypertension, and smoking history were recorded. Selective medium was applied to cultivate and count Escherichia coli, Enterococcus, Staphylococcus, Bifidobacterium, Saccharomyces, Lactobacillus and Peptococcus according to the plate counting method. 16S rRNA gene sequencing was performed to analyze the flora diversity. Logistic regression was performed to analyze the influencing factors of postoperative pulmonary infection in patients with esophageal cancer. ResultsThere were no significant differences in the Chaol index, Shannon index and Simpson index between the two groups (all P＞0.05). Compared with the non-infection group, the infection group had significantly higher proportions of patients aged ≥60 years, smoking history ≥20 years, preoperative FEV1/FVC ＜70%, and operation time ≥4 hours, higher counts of Escherichia coli, Enterococcus and Staphylococcus, and significantly lower counts of Bifidobacteria, Saccharomyces, Lactobacillus and Peptococcus (all P＜0.05). Escherichia coli and Enterococcus were independent risk factors for postoperative pulmonary infection in patients with esophageal cancer, while Bifidobacterium was a protective factor affecting postoperative pulmonary infection in patients with esophageal cancer (all P＜0.05). ConclusionThere are significant differences in the preoperative intestinal flora number between patients with pulmonary infection after esophagus cancer surgery and those without pulmonary infection. Escherichia coli, Enterococcus and Bifidobacterium are the influencing factors of postoperative pulmonary infection in patients with esophageal cancer.