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中国临床药理学与治疗学 ›› 2022, Vol. 27 ›› Issue (6): 639-644.doi: 10.12092/j.issn.1009-2501.2022.06.006

• 基础研究 • 上一篇    下一篇

肠道菌群紊乱对吸入麻醉患者术后认知功能障碍的影响

陈健,兰宇,吴勇,沈伯雄   

  1. 海南西部中心医院麻醉科,儋州 571700,海南
  • 收稿日期:2022-04-21 修回日期:2022-05-19 出版日期:2022-06-26 发布日期:2022-07-08
  • 通讯作者: 沈伯雄,男,主任医师,研究方向:临床麻醉。 E-mail: bxshen@aliyun.com
  • 作者简介:陈健,男,本科,副主任医师,研究方向:临床麻醉围术期的监管。
  • 基金资助:
    2021年度海南省卫生健康行业科研项目(21A200251)

Effects of intestinal flora disturbance on postoperative cognitive dysfunction in patients with inhalation anesthesia

CHEN Jian, LAN Yu, WU Yong, SHEN Boxiong   

  1. Department of Anesthesiology, Hainan West Central Hospital, Danzhou 571700, Hainan, China
  • Received:2022-04-21 Revised:2022-05-19 Online:2022-06-26 Published:2022-07-08

摘要: 目的:应用倾向性评分匹配法探究肠道菌群紊乱对吸入麻醉患者术后认知功能障碍的影响。方法:将2018年1月至2021年12月于我院行吸入麻醉的患者纳入研究,选取91例出现术后认知功能障碍的患者作为认知障碍组,85例术后无认知功能障碍的患者为对照组,应用倾向性评分匹配法对两组患者进行匹配,比较两组患者的一般临床资料,在术前提取两组患者粪便样本中的细菌DNA,并进行16S rRNA测序对两组患者肠道菌群差异进行分析。结果:最终两组共20对匹配成功,两组患者的年龄、性别等一般资料无明显差异(均P>0.05);PCoA分析示,尽管两组患者的粪便样本在PCoA图上存在部分重叠,但PCoA散点图显示两组样本间仍存在明显差异;LEfse多级物种差异判别分析显示,在属水平上,认知障碍组有6个菌属丰度更高;认知障碍组的肠道内类芽孢杆菌属、毛螺菌属、厚壁菌门、梭菌科、奈瑟氏菌科、奈瑟菌属丰度增加,主要表现为克雷伯氏杆菌、普氏菌、肠杆菌科、梭菌目、毛螺菌科、嗜胆菌属、变形菌门、梭状芽孢杆菌、肠杆菌科等细菌的富集。 结论:吸入麻醉患者出现认知功能障碍与患者肠道菌群紊乱相关,主要表现为雷伯氏杆菌、普氏菌等细菌的富集。

关键词: 肠道菌群, 吸入麻醉, 认知功能障碍, 相关性分析, 倾向性评分

Abstract: AIM: To explore the effect of intestinal flora disturbance on postoperative cognitive dysfunction in patients with inhalation anesthesia by using propensity score matching method.  METHODS: Patients received inhalation anesthesia of patients between January 2018 and December 2021 in our hospital were included in the study. 91 cases of postoperative cognitive dysfunction patients as cognitive impairment group, 85 cases of postoperative cognitive dysfunction patients as control group. Propensity score matching method was used to compare the clinical data and bacterial DNA, which was extracted from the stool samples of the two groups before surgery. And 16S rRNA sequencing was performed to analyze the differences of intestinal flora between the two groups. RESULTS: A total of 20 pairs of patients were successfully matched between the two groups. There was no significant difference in age, gender and other general information between the two groups (P>0.05). PCoA analysis showed that although there was some overlap in the PCoA plot of stool samples from the two groups, the PCoA scatter plot showed significant differences between the two groups. LEfse multistage species difference discriminant analysis showed that at the genus level, the abundance of 6 bacteria genera was higher in the cognitive impairment group. The intestinal bacillus genus, MAO spirillum, thick wall bacteria door, clostridium, neisseria bacterium, neisseria bacteria genera abundance increased in the cognitive impairment group, majorly the klebsiella bacillus clostridium, platts bacteria and enterobacteriaceae, mesh, wool spirillum, addicted to bile bacteria genera, door deformation, clostridium, enterobacteriaceae bacteria enriched, etc. CONCLUSION: Cognitive dysfunction in patients with inhalation anesthesia is related to intestinal flora disorder, which is mainly manifested by the enrichment of Bacteria such as Leiborella and Prevotella.

Key words: intestinal flora, inhalation anesthesia, cognitive dysfunction, correlation analysis, tendency score

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