肝硬化患者肠道微生态与肌量减少的相关性研究*

doi:10.3969/j.issn.1672-5069.2020.04.003

摘要/Abstract

摘要： 目的探讨肝硬化患者肌量减少与肠道微生态的相关性。方法 2019年4月～2019年10月在山西白求恩医院住院的60例肝硬化患者和同期30例健康者,取粪便,进行宏基因组测序。根据第三腰椎骨骼肌指数(L3 SMI)将肝硬化患者分为肌量减少组24例和肌量正常组36例,分析两组间肠道微生态的差异。结果肌量减少的肝硬化组L3 SMI为(30.9±5.1)cm²/m²,显著低于肌量正常组【(52.0±12.9)cm²/m²,P＜0.05】;肌量减少的肝硬化组shannon指数为(2.1±0.8),显著低于肌量正常组【(2.7±0.8),P＜0.05】;在门水平,肝硬化组变形菌门相对丰度为(6.2±7.9)%,显著高于健康人【(1.7±1.5)%,P＜0.05】;肌量减少组变形菌门相对丰度为(7.7±9.3)%,显著高于肌量正常组【(3.6±4.1)%,P＜0.05】;在种水平,两组之间存在16个菌种的差异(P＜0.05),进一步通过关联分析发现毛螺科菌和多形棒状杆菌相对丰度与SMI呈显著正相关(P＜0.05)。结论肝硬化患者肌量减少与肠道微生态改变相关,改善肝硬化患者的肠道微生态可能有助于改善肝硬化患者的营养不良。

关键词: 肝硬化, 肌量减少, 肠道菌群, 宏基因组测序

Abstract: Objective The purpose of this study was to investigate the correlation of muscle mass loss to intestinal microecology in patients with liver cirrhosis (LC). Methods Fecal specimens were collected from 60 patients with LC and 30 healthy persons in the same period in Shanxi Bethune Hospital from April 2019 through October 2019. All the samples were sequenced by metagenomics. According to the third lumbar skeletal muscle index (L3 SMI), the patients with LC were divided into muscle mass loss group (n=24) and normal muscle group (n=36), and the differences in intestinal microecology between the two groups were analyzed. Results The L3 SMI in patients with muscle mass loss was (30.9±5.1)cm²/m², much lower than 【(52.0±12.9)cm²/m²,P＜0.05】 in patients with normal muscle; the shannon index in the muscle mass loss group was (2.1±0.8), which was significantly lower than【(2.7±0.8), P<0.05】in the normal muscle group; on phylum level, the relative abundance of Proteobacteria in patients with LC was (6.2±7.9)%, which was significantly higher than【(1.7±1.5)%, P<0.05】in the healthy persons, and the relative abundance of Proteobacteria in patients with muscle mass loss was (7.7±9.3)%, significantly higher than【(3.6±4.1)%, P<0.05】in those with normal muscle; on species level, there was a difference of 16 strains between the two groups of patients with LC (P<0.05), and further analysis found that the relative abundance of Lachnospiraceae bacterium and Bacteroides uniforms were positively correlated with SMI(P<0.05). Conclusion Muscle mass loss in patients with cirrhosis is related to intestinal microecological imbalances. The improvement of intestinal microecology in patients with cirrhosis might help the improvement of malnutrition in this setting.

Key words: Liver cirrhosis, Muscle mass loss, Intestinal flora, Metagenomic sequencing

郝莎莎, 任晓静, 原丽莉, 姚佳. 肝硬化患者肠道微生态与肌量减少的相关性研究^*[J]. 实用肝脏病杂志, 2020, 23(4): 462-466.

Hao Shasha, Ren Xiaojing, Yuan Lili, et al. Correlation of intestinal microecology to muscle mass loss in patients with liver cirrhosis[J]. Journal of Practical Hepatology, 2020, 23(4): 462-466.

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肝硬化患者肠道微生态与肌量减少的相关性研究^*

Correlation of intestinal microecology to muscle mass loss in patients with liver cirrhosis

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