[1]陈 婕,张红梅,谭春艳.脓毒症患者肠道菌群生态特征与血清D- 乳酸、sTREM1 和MCP-1 表达水平的相关性研究[J].现代检验医学杂志,2023,38(04):139-142+179.[doi:10.3969/j.issn.1671-7414.2023.04.025]
　CHEN Jie,ZHANG Hongmei,TAN Chunyan.Correlation between Intestinal Flora Ecological Characteristics and Serum D-lactic Acid，sTREM1 and MCP-1 Expression Levels in Patients with Sepsis[J].Journal of Modern Laboratory Medicine,2023,38(04):139-142+179.[doi:10.3969/j.issn.1671-7414.2023.04.025]
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脓毒症患者肠道菌群生态特征与血清D- 乳酸、sTREM1 和MCP-1 表达水平的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年04期
页码:
139-142+179
栏目:
论著
出版日期:
2023-07-15

文章信息/Info

Title:
Correlation between Intestinal Flora Ecological Characteristics and Serum D-lactic Acid，sTREM1 and MCP-1 Expression Levels in Patients with Sepsis
文章编号:
1671-7414（2023）04-139-05
作者:
陈 婕; 张红梅; 谭春艳
（遂宁市中心医院检验科，四川遂宁 629000）
Author(s):
CHEN Jie;  ZHANG Hongmei;  TAN Chunyan
（Department of Clinical Laboratory, Suining Central Hospital, Sichuan Suining 629000, China）
关键词:
脓毒症; 肠道菌群; D- 乳酸; 可溶性髓样细胞触发性受体-1; 单核细胞趋化蛋白-1
分类号:
R631；R446.1
DOI:
10.3969/j.issn.1671-7414.2023.04.025
文献标志码:
A
摘要:
目的　研究脓毒症（sepsis）患者肠道菌群生态特征与血清D- 乳酸（D-lactate）、可溶性髓样细胞触发性受体-1（soluble triggering receptor expressed on myeloid cells-1，sTREM1）和单核细胞趋化蛋白-1（monocyte chemoattractantprotein-1，MCP-1）表达水平的相关性。方法　将遂宁市中心医院2019.06 ～ 2022.06 期间接收的46 例脓毒症患者纳为脓毒症组，患者符合Sepsis3.0 中相关诊断标准；同期45 例入住ICU 但无脓毒症者纳为非脓毒症组，50 例健康志愿者纳为对照组。收集其粪便标本，采用16S rRNA 基因测序技术对三组粪便标本进行菌群检测分析，采集三组外周静脉血，检测血清D- 乳酸、sTREM1 及MCP-1 水平，分析脓毒症患者肠道菌群与血清D- 乳酸、sTREM1 及MCP-1 水平之间的关系。结果　脓毒症组、非脓毒症组和对照组肠道菌群ACE 指数（476.59±46.69, 483.69±53.69, 490.15±55.48）比较，差异无统计学意义（F=0.797，P>0.05），三组Chaol（365.45±43.58, 465.69±50.37; 473.58±52.15），Shannon（5.06±1.06, 5.56±1.17, 5.74±1.26）及Simpaon（0.83±0.17, 0.94±0.21, 0.96±0.22）指数比较，差异均有统计学意义（F=4.292 ～ 71.632，均P<0.05），其中脓毒症组患者Chaol, Shannon 及Simpaon 指数均低于非脓毒症组与对照组，差异具有统计学意义（t=8.773，2.234，2.811；12.360，2.911，3.311，均P ＜ 0.05）。对样本OTU 聚类分析后发现，非脓毒症组与对照组患者肠道微生态中拟杆菌门+ 厚壁菌门占比均超过90%，脓毒症组拟杆菌门+ 厚壁菌门占比低于其余两组（69.24% vs 92.39%，91.67%），变形菌门占比高于其余两组（18.66% vs 5.46% ，5.06%），差异具有统计学意义（F=16.584, 6.741，均P<0.05），其中脓毒症组与非脓毒症组、对照组对比，差异均有统计学意义（χ2=4.558，3.984；4.623，4.058，均P ＜ 0.05）。脓毒症组、非脓毒症组及对照组间血清D- 乳酸（4.26±0.85，0.69±0.16，0.53±0.12），sTREM1（183.16±23.26，60.15±19.48，42.48±10.34）及MCP-1（563.15±63.69，365.73±55.78，311.42±51.74）水平呈依次下降趋势，差异均有统计学意义（F=822.762，806.300，311.42，均P<0.001）；其中脓毒症组和非脓毒症组相比（t=28.557，27.435，15.716，均P ＜ 0.05），脓毒症组和对照组相比（t=21.417，38.888，22.411，均P ＜ 0.05），非脓毒症组和对照组相比（t=5.576，5.662，4.987，均P ＜ 0.05），差异均有统计学意义。相关性分析提示，脓毒症组患者肠道内拟杆菌门及厚壁菌门与其血清D- 乳酸、sTREM1，MCP-1 水平均呈负相关（r=-0.364，-0.377；-0.417，-0.302；-0.384，-0.312，均P ＜ 0.05），变形菌门与其血清D- 乳酸、sTREM1 和MCP-1 水平均呈正相关（r=0.411，0.343，0.395，均P ＜ 0.001）。结论　脓毒症患者肠道菌群多样性下降，肠道内拟杆菌门与厚壁菌门占比下降，变形菌门占比上升，肠道菌群失衡可能联合肠道屏障障碍与炎症反应共同参与脓毒症的发生。
Abstract:
Objective　To investigate the correlation between the ecological characteristics of intestinal flora and the expression levels of serum D-lactic acid, soluble triggering receptor expressed on myeloid cells-1 (sTREM1) and monocyte chemoattractant protein-1 (MCP-1) in patients with sepsis. Methods　46 cases of sepsis admitted to Suining Central Hospital from June 2019 to June 2019 were included as sepsis group, and the patients met relevant diagnostic criteria in Sepsis3.0. Meantime, another 50 healthy individuals were set as control group. Fecal samples were collected, and 16S rRNA gene sequencing technology was used to detect the gut microbiota. Peripheral venous blood was collected, and serum levels of D-lactate, sTREM1 and MCP-1 were measured. Thereafter, the correlation of gut microbiota with the serum levels of D-lactate, sTREM1 and MCP-1 in patients with sepsis was discussed. Results　There was no significant difference in intestinal flora ACE index(476.59±46.69,483.69±53.69, 490.15±55.48) among the spesis group, non-sepsis group and control group(F=0.797, P>0.05), while there was significant difference in Chaol(365.45±43.58, 465.69±50.37; 473.58±52.15), Shannon(5.06±1.06, 5.56±1.17, 5.74±1.26) and Simpaon(0.83±0.17, 0.94±0.21, 0.96±0.22) index among the three groups(F=4.292 ～ 71.632, all P<0.05).In the sepsis group，Chaol，Shannon and Simpaon index were lower than those in non-sepsis group and control group, the differences were statistically significant(t=8.773，2.234，2.811，all P<0.05).After OTU clustering analysis of samples, it was found that Bacteroides+Firmicutes accounted for more than 90% in the intestinal microecology of patients in the non-sepsis group and the control group, and the proportion of Bacteroides+Firmicutes in the sepsis group was lower than that in the other two groups(69.24% vs 92.39%，91.67%). The proportion of Proteobacteria was higher than that in the other two groups(18.66% vs 5.46%，5.06%), and the differences was statistically significant(χ2=16.584, 6.741，all P<0.05). There was a comparison between the sepsis group and the non-sepsis group， the comparison between sepsis group and control group，and differences were statistically significant(χ2=4.558，3.984；4.623, 4.058, all P<0.05). Serum D-lactic acid（4.26±0.85，0.69±0.16，0.53±0.12） between sepsis，non-sepsis and control groups，sTREM1（183.16±23.26 ，60.15±19.48 ，42.48±10.34）and MCP-1 （563.15±63.69，365.73±55.78，311.42±51.74）showed a downward trend, and the differences were statistically significant （F=822.762，806.300，311.42，all P<0.001）. The sepsis group was compared with the non-sepsis group(t=28.557， 27.435，15.716，all P<0.05). Sepsis group was compared with control group(t=21.417，38.888，22.411，all P<0.05).The non-sepsis group was compared with the control group(t=5.576, 5.662, 4.987，all P<0.05), and the differences were statistically significant, respectively. Correlation analysis indicated that Bacteroides and Firmicutes in the intestinal tract of sepsis group were negatively correlated with their serum D-lactic acid，sTREM1，MCP-1 levels(r=-0.364, -0.377; -0.417, -0.302； -0.384, -0.312, all P<0.05). Proteobacteria were positively correlated with serum D-lactic acid，sTREM1 and MCP-1 levels(r=0.411, 0.343, 0.395, all P<0.001).Conclusion　In sepsis patients, the diversity of gut microbiota decreases, and patients decreased proportion of phyla Bacteroidetes and Firmicutes, and increased proportion of Proteobacteria, furthermore, the imbalance of gut microbiota combined with intestinal barrier disorder and inflammatory response may be involved in the occurrence of sepsis.

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备注/Memo

备注/Memo:
作者简介：陈婕（1985-），女，本科，主管检验技师，研究方向：生化，E-mail：5680597@qq.com。
通讯作者：谭春艳（1989-），女，本科，主管技师，研究方向：免疫。
更新日期/Last Update: 2023-07-15