首都医科大学学报 ›› 2020, Vol. 41 ›› Issue (2): 243-248.doi: 10.3969/j.issn.1006-7795.2020.02.016

• 临床研究 • 上一篇    下一篇

反流性食管炎治疗效果与食管下段菌群构成变化的关系研究

余英, 高峰, 张杰   

  1. 首都医科大学附属北京安贞医院消化内科, 北京 100029
  • 收稿日期:2019-10-12 出版日期:2020-04-21 发布日期:2020-04-16
  • 通讯作者: 张杰 E-mail:zhangjie4155@sina.com
  • 基金资助:
    首都卫生发展科研专项项目(2018-2-1053)。

Study on the relationship between the changes of microbiota and therapeutic effect in patients with reflux esophagitis

Yu Ying, Gao Feng, Zhang Jie   

  1. Department of Gastroenterology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
  • Received:2019-10-12 Online:2020-04-21 Published:2020-04-16
  • Supported by:
    This study was supported by Capitals Funds for Health Improvement and Research (2018-2-1053).

摘要: 目的 研究食管下段菌群变化与反流性食管炎患者治疗效果的关系。方法 对反流性食管炎患者给予质子泵抑制剂规范治疗,在治疗前、后分别采集食管下段黏膜样本,根据治疗效果分为愈合组和愈合不良组,采用宏基因组学高通量DNA测序和生物信息学分析技术,比较治疗前、后食管下段黏膜菌群构成变化。结果 对愈合组患者治疗前与治疗后食管下段黏膜菌群丰度进行比较发现:乳杆菌科、乳杆菌属、双歧杆菌属、螺杆菌属丰度差异有统计学意义[2.7%(1.5%~3.2%)vs 4.8%(3.0%~10.7%)、2.7%(1.5%~(P=0.001、P=0.001、P=0.042、P=0.049)。同时对愈合组和愈合不良组治疗后食管下段黏膜菌群丰度进行比较发现:双歧杆菌属、螺杆菌属丰度差异有统计学意义[1.4%(1.0%~2.2%)vs 0.7%(0.4%~1.1%)、0.12%(0.08%~0.21%)vs 0.07%(0.03%~0.09%)](P=0.003、P=0.014)。结论 质子泵抑制剂治疗反流性食管炎的治疗效果与食管下段黏膜菌群构成变化相关,愈合组有益菌丰度明显增高。

关键词: 反流性食管炎, 高通量DNA测序技术, 菌群构成, 治疗效果

Abstract: Objective To study the relationship between the changes of lower esophageal mucosal microbiota and the therapeutic effect in the patients with reflux esophagitis. Methods The patients with reflux esophagitis were recruited and undertook standard proton pump inhibitor (PPI) therapy for 8 weeks. They were divided into mucosal healing group and poor healing group. The high-throughput nucleotide sequencing and bioinformatics analysis techniques were used to analyze the composition of the distal esophageal mucosal microbiota in the reflux esophagitis before and after PPI therapy. Results In the healing group, there were significant differences on the abundances of the lower esophageal mucosa between before and after PPI therapy at the level of genus:Lactobacillaceae, Lactobacillus, Bifidobacterium and Helicobacter [2.7%(1.5%-3.2%) vs 4.8%(3.0%-10.7%), 2.7%(1.5%-3.2%) vs 4.8%(3.0%-10.7%), 0.7%(0.6%-10.7%) vs 1.4%(1.0%-2.2%), 0.08%(0.04%-0.13%) vs 0.12%(0.08%-0.21%)](P=0.001, P=0.001, P=0.042, P=0.049, respectively). The abundances of Bifidobacterium and Helicobacter at the level of genus in the healing group after the PPI therapy were significant increasing than those in the poor healing group[1.4%(1.0%-2.2%) vs 0.7%(0.4%-1.1%), 0.12%(0.08%-0.21%) vs 0.07%(0.03%-0.09%)] (P=0.003, P=0.014). Conclusion The changes in the lower esophageal mucosal microbiota after PPI therapy in patients with reflux esophagitis are related to the therapeutic effect. And in the healing group, the proportion of beneficial bacteria significantly increased.

Key words: reflux esophagitis, high-throughput DNA sequencing, microbiota, therapeutic effect

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