氨基酸型肠内营养制剂支持后克罗恩病患者肠道微生物和非靶向代谢组学指标的分析

探讨氨基酸型肠内营养制剂支持后克罗恩病患者的肠道微生物和非靶向代谢组学指标的变化，为该类患者的治疗提供参考。

选择我院收治的20例克罗恩病活动期患者作为研究对象，所有患者均采用氨基酸型肠内营养制剂进行支持治疗。比较患者治疗前后肠道菌群结构、菌群多样性以及非靶向代谢组学检测结果的差异。

治疗后，患者肠道乳杆菌属（t=5.200，P＜0.001）、大肠埃希菌（t=11.974，P＜0.001）、克雷伯菌属（t=15.033，P＜0.001）、糖单胞菌（t=12.166，P＜0.001）、恶臭假单胞菌（t=31.063，P＜0.001）、肠球菌属（t=28.867，P＜0.001）数量均显著升高；同时患者肠道菌群OUTs（t=40.435，P＜0.001）、Observed species（t=5.475，P＜0.001）、Chao1指数（t=12.348，P＜0.001）、Simpson指数（t=2.961，P=0.005）、Shannon指数（t=3.330，P=0.002）均显著升高。相比治疗前，治疗后患者血清以及粪便中的氨基酸、多肽、脂肪酸、胆固醇及碳水化合物水平均显著改善。

氨基酸型肠内营养制剂支持后，克罗恩病患者肠道菌群丰度提高，同时患者脂质代谢的改善可能与氧化应激反应通路相关联。

Intestinal microbiome and non-target metabonomics indicators in patients with Crohn's disease after amino acid-based enteral nutrition support

ObjectiveTo observe the changes of non-target metabonomics indicators and intestinal flora in patients with Crohn's disease (CD) supported with amino acid-based enteral nutrition preparation, providing a reference for the treatment. MethodsTwenty patients with CD during the active phase treated in our hospital were selected as the subjects. All the patients were treated with amino acid-type enteral nutrition preparation. The differences in the structure and diversity of intestinal flora and non-target metabolomics before and after treatment were compared. ResultsAfter treatment, the intestinal Lactobacillus (t=5.200, P＜0.001), Escherichia coli (t=11.974, P＜0.001), Klebsiella (t=15.033, P＜0.001), Saccharomonospora (t=12.166, P＜0.001), Pseudomonas (t=31.063, P＜0.001), Enterococci (t=28.867, P＜0.001), intestinal flora OUTs (t=40.435, P＜0.001), Observed species (t=5.475, P＜0.001), Chao1 index (t=12.348, P＜0.001), Simpson index (t=2.961, P=0.005) and Shannon index (t=3.330, P=0.002) significantly increased; the levels of amino acids, polypeptides, fatty acids, cholesterol and carbohydrates in the serum and feces of patients were significantly improved compared with those before treatment. ConclusionAfter the support of amino acid based enteral nutrition, the abundance of microbial communities in patients with CD increases, and the improvement of lipid metabolism may be associated with the pathways related to oxidative stress response.