|本期目录/Table of Contents|

[1]林玫秀,张苏明.脓毒症相关性脑病患者肠道菌群紊乱的临床研究[J].天津医科大学学报,2025,31(06):563-567.[doi:10.20135/j.issn.1006-8147.2025.06.0563]
　LIN Meixiu,ZHANG Suming.Clinical investigation of gut microbiota dysbiosis in patients with sepsis-associated encephalopathy[J].Journal of Tianjin Medical University,2025,31(06):563-567.[doi:10.20135/j.issn.1006-8147.2025.06.0563]
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脓毒症相关性脑病患者肠道菌群紊乱的临床研究(PDF)

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
31卷
期数:
2025年06期
页码:
563-567
栏目:
临床医学
出版日期:
2025-11-20

文章信息/Info

Title:
Clinical investigation of gut microbiota dysbiosis in patients with sepsis-associated encephalopathy
文章编号:
1006-8147(2025)06-0563-05
作者:
林玫秀1;  张苏明2; 3
（1.徐州医科大学附属医院神外重症医学科，徐州 221000；2.徐州医科大学附属医院重症医学科，徐州 221000；3.天津医科大学总医院急诊医学科，天津 300052）
Author(s):
LIN Meixiu1;  ZHANG Suming2; 3
（1. Department of Neurosurgical Intensive Care Unit， The Affiliated Hospital of Xuzhou Medical University， Xuzhou 221000， China； 2. Department of Intensive Care Unit， The Affiliated Hospital of Xuzhou Medical University， Xuzhou 221000， China； 3. Department of Emergency Medicine， General Hospital， Tianjin Medical University， Tianjin 300052， China）
关键词:
脓毒症相关性脑病; 肠道菌群; 16S rDNA测序; 多样性指数
Keywords:
sepsis-associated encephalopathy;  gut microbiota;  16S rDNA sequencing;  diversity index
分类号:
R446.1
DOI:
10.20135/j.issn.1006-8147.2025.06.0563
文献标志码:
A
摘要:
目的：对比脓毒症相关性脑病（SAE）患者与健康志愿者的肠道菌群，探究SAE患者肠道菌群组成的特点。方法：采用前瞻性研究方法，选取2022年7月至2023年7月在徐州医科大学附属医院重症医学科收治的SAE患者 15 例（SAE组）及同期健康志愿者15名（正常组）。通过16S rDNA测序技术分析两组间的α多样性、β多样性和肠道菌群组成的差异。结果：与正常组相比，SAE组肠道菌群丰度指数（Ace指数、Chao指数）与多样性指数（Shannon指数）均显著降低，差异均具有统计学意义（t=2.61、2.47、2.07，均P<0.05）。β多样性分析显示，与正常组相比，SAE组肠道菌群结构发生明显变化，且个体间差异性更大。在门水平上，SAE组丰度最高的菌依次为厚壁菌门 （45.61%）、变形菌门 （26.86%）和拟杆菌门 （21.07%）；在科水平上，SAE组丰度最高的菌依次为肠杆菌科（16.41%）、乳酸杆菌科（13.56%）和肠球菌科（11.71%）；在属水平上，SAE组丰度最高的菌依次为大肠杆菌-志贺氏菌属（12.91%）、肠球菌属（11.72%）和拟杆菌属（11.38%）。LEfSe分析显示，与正常组相比，SAE组变形菌门、肠球菌科、肠杆菌科和大肠杆菌-志贺氏菌属显著升高（LDA 值为4.89、4.88、3.83、3.72，均P<0.05）。结论： SAE患者存在显著的肠道菌群紊乱，其菌群丰度和多样性降低，菌群组成结构发生显著变化。变形菌门、肠球菌科、肠杆菌科和大肠杆菌-志贺氏菌属等菌群的异常增加可能与SAE的发生、发展相关。
Abstract:
Objective： To compare the gut microbiota of patients with sepsis-associated encephalopathy（SAE） and healthy volunteers， aiming to clarify the characteristics of gut microbiota composition in patients with SAE. Methods： This prospective study enrolled 15 SAE patients （SAE group） admitted to the Department of Intensive Care Unit at the Affiliated Hospital of Xuzhou Medical University from July 2022 to July 2023 and 15 healthy volunteers （normal group） during the same period. The differences in α-diversity， β-diversity， and gut microbiota composition between the two groups were analyzed using 16S rDNA sequencing technology. Results： Compared to the normal group， the gut microbiota richness indices （Ace index and Chao index） and diversity index （Shannon index） of the SAE group were significantly lower， with statistical significance （t=2.61， 2.47， 2.07， all P<0.05）. The β-diversity analysis showed significant changes in the gut microbiota structure of the SAE group compared to the normal group， with greater interindividual variability. At the phylum level， the most abundant bacteria in the SAE group were Firmicutes （45.61%）， Proteobacteria （26.86%）， and Bacteroidetes （21.07%）. At the family level， the most abundant bacteria in the SAE group were Enterobacteriaceae （16.41%）， Lactobacillaceae （13.56%）， and Enterococcaceae （11.71%）. At the genus level， the most abundant bacteria in the SAE group were Escherichia-Shigella （12.91%）， Enterococcus （11.72%）， and Bacteroides （11.38%）. LEfSe analysis revealed significant increased in Proteobacteria， Enterococcaceae， Enterobacteriaceae， and Escherichia-Shigella in the SAE group compared to the normal group （The LDA scores were 4.89， 4.88， 3.83， 3.72， all P<0.05）. Conclusion： SAE patients exhibit significant gut microbiota dysbiosis， characterized by reduced microbial richness and diversity， and altered community structure. The abnormal increase in Proteobacteria， Enterococcaceae， Enterobacteriaceae， and Escherichia-Shigella may be associated with the occurrence and development of SAE.Objective： To compare the gut microbiota of patients with sepsis-associated encephalopathy（SAE） and healthy volunteers， aiming to clarify the characteristics of gut microbiota composition in patients with SAE. Methods： This prospective study enrolled 15 SAE patients （SAE group） admitted to the Department of Intensive Care Unit at the Affiliated Hospital of Xuzhou Medical University from July 2022 to July 2023 and 15 healthy volunteers （normal group） during the same period. The differences in α-diversity， β-diversity， and gut microbiota composition between the two groups were analyzed using 16S rDNA sequencing technology. Results： Compared to the normal group， the gut microbiota richness indices （Ace index and Chao index） and diversity index （Shannon index） of the SAE group were significantly lower， with statistical significance （t=2.61， 2.47， 2.07， all P<0.05）. The β-diversity analysis showed significant changes in the gut microbiota structure of the SAE group compared to the normal group， with greater interindividual variability. At the phylum level， the most abundant bacteria in the SAE group were Firmicutes （45.61%）， Proteobacteria （26.86%）， and Bacteroidetes （21.07%）. At the family level， the most abundant bacteria in the SAE group were Enterobacteriaceae （16.41%）， Lactobacillaceae （13.56%）， and Enterococcaceae （11.71%）. At the genus level， the most abundant bacteria in the SAE group were Escherichia-Shigella （12.91%）， Enterococcus （11.72%）， and Bacteroides （11.38%）. LEfSe analysis revealed significant increased in Proteobacteria， Enterococcaceae， Enterobacteriaceae， and Escherichia-Shigella in the SAE group compared to the normal group （The LDA scores were 4.89， 4.88， 3.83， 3.72， all P<0.05）. Conclusion： SAE patients exhibit significant gut microbiota dysbiosis， characterized by reduced microbial richness and diversity， and altered community structure. The abnormal increase in Proteobacteria， Enterococcaceae， Enterobacteriaceae， and Escherichia-Shigella may be associated with the occurrence and development of SAE.

参考文献/References:

[1] ZHOU Y， BAI L， TANG W. Research progress in the pathogenesis of sepsis-associated encephalopathy[J]. Heliyon， 2024， 10（12）： e33458.
[2] LI Z， ZHANG F， SUN M， et al. The modulatory effects of gut microbes and metabolites on blood-brain barrier integrity and brain function in sepsis-associated encephalopathy[J]. Peer J， 2023， 11： e15122.
[3] HUANG Z B， ZHANG G P， LU C X， et al. Gut microbiota-derived 3-indoleacetic acid confers a protection against sepsis-associated encephalopathy through microglial aryl hydrocarbon receptors[J]. Exp Neurol， 2025， 384： 115055.
[4] 韩晋， 陈淑媛， 毓青. 肠道菌群失调通过促进炎性反应影响颈动脉粥样硬化的形成[J]. 天津医科大学学报， 2021， 27（3）： 252-255.
[5] TANG C F， WANG C Y， WANG J H， et al. Short-chain fatty acids ameliorate depressive-like behaviors of high fructose-fed mice by rescuing hippocampal neurogenesis decline and blood-brain barrier damage[J]. Nutrients， 2022， 14（9）： 1882.
[6] KULLBERG R F J， WIERSINGA W J， HAAK B W. Gut microbiota and sepsis： from pathogenesis to novel treatments[J]. Curr Opin Ga-stroenterol， 2021， 37（6）： 578-585.
[7] EVANS L， RHODES A， ALHAZZANI W， et al. Surviving sepsis campaign： international guidelines for management of sepsis and septic Shock 2021[J]. Crit Care Med， 2021， 49（11）： e1063-e1143.
[8] LIN X， LIN C， LI X， et al. Gut microbiota dysbiosis facilitates susceptibility to bloodstream infection[J]. J Microbiol， 2024， 62（12）： 1113-1124.
[9] LI Z， LIN L， KONG Y， et al. Gut microbiota， circulating inflammatory proteins and sepsis： a bi-directional mendelian randomization study[J]. Front Cell Infect Microbiol， 2024， 14： 1398756.
[10] LUAN F， ZHOU Y， MA X， et al. Gut microbiota composition and changes in patients with sepsis： potential markers for predicting survival[J]. BMC Microbiol， 2024， 24（1）： 45.
[11] LITVAK Y， BYNDLOSS M X， TSOLIS R M， et al. Dysbiotic proteobacteria expansion： a microbial signature of epithelial dysfunction[J]. Curr Opin Microbiol， 2017， 39： 1-6.
[12] HAGHIKIA A， JORG S， DUSCHA A， et al. Dietary fatty acids directly impact central nervous system autoimmunity via the small intestine[J]. Immunity， 2016， 44（4）： 951-953.
[13] ZHANG Q， LU C， FAN W， et al. Application background and mechanism of short-chain fatty acids in sepsis-associated encephalopathy[J]. Front Cell Infect Microbiol， 2023， 13： 1137161.
[14] CHEN L， LI H， LI J， et al. Lactobacillus rhamnosus GG treatment improves intestinal permeability and modulates microbiota dysbiosis in an experimental model of sepsis[J]. Int J Mol Med， 2019， 43（3）： 1139-1148.
[15] AGUDELO-OCHOA G M， VALDES-DUQUE B E， GIRALDO-GIRALDO N A， et al. Gut microbiota profiles in critically ill patients， potential biomarkers and risk variables for sepsis[J]. Gut Microbes， 2020， 12（1）： 1707610.
[16] LIU W， CHENG M， LI J， et al. Classification of the gut microbiota of patients in intensive care units during development of sepsis and septic shock[J]. Genomics Proteomics Bioinformatics， 2020， 18（6）： 696-707.
[17] CHANG B T， WANG Y， TU W L， et al. Regulatory effects of mangiferin on LPS-induced inflammatory responses and intestinal flora imbalance during sepsis[J]. Food Sci Nutr， 2024， 12（3）： 2068-2080.
[18] CAI Y， DONG Y， HAN M， et al. Lacticaseibacillus paracasei LC86 mitigates age-related muscle wasting and cognitive impairment in SAMP8 mice through gut microbiota modulation and the regulation of serum inflammatory factors[J]. Front Nutr， 2024， 11： 1390433. [1] ZHOU Y， BAI L， TANG W. Research progress in the pathogenesis of sepsis-associated encephalopathy[J]. Heliyon， 2024， 10（12）： e33458.
[2] LI Z， ZHANG F， SUN M， et al. The modulatory effects of gut microbes and metabolites on blood-brain barrier integrity and brain function in sepsis-associated encephalopathy[J]. Peer J， 2023， 11： e15122.
[3] HUANG Z B， ZHANG G P， LU C X， et al. Gut microbiota-derived 3-indoleacetic acid confers a protection against sepsis-associated encephalopathy through microglial aryl hydrocarbon receptors[J]. Exp Neurol， 2025， 384： 115055.
[4] 韩晋， 陈淑媛， 毓青. 肠道菌群失调通过促进炎性反应影响颈动脉粥样硬化的形成[J]. 天津医科大学学报， 2021， 27（3）： 252-255.
[5] TANG C F， WANG C Y， WANG J H， et al. Short-chain fatty acids ameliorate depressive-like behaviors of high fructose-fed mice by rescuing hippocampal neurogenesis decline and blood-brain barrier damage[J]. Nutrients， 2022， 14（9）： 1882.
[6] KULLBERG R F J， WIERSINGA W J， HAAK B W. Gut microbiota and sepsis： from pathogenesis to novel treatments[J]. Curr Opin Ga-stroenterol， 2021， 37（6）： 578-585.
[7] EVANS L， RHODES A， ALHAZZANI W， et al. Surviving sepsis campaign： international guidelines for management of sepsis and septic Shock 2021[J]. Crit Care Med， 2021， 49（11）： e1063-e1143.
[8] LIN X， LIN C， LI X， et al. Gut microbiota dysbiosis facilitates susceptibility to bloodstream infection[J]. J Microbiol， 2024， 62（12）： 1113-1124.
[9] LI Z， LIN L， KONG Y， et al. Gut microbiota， circulating inflammatory proteins and sepsis： a bi-directional mendelian randomization study[J]. Front Cell Infect Microbiol， 2024， 14： 1398756.
[10] LUAN F， ZHOU Y， MA X， et al. Gut microbiota composition and changes in patients with sepsis： potential markers for predicting survival[J]. BMC Microbiol， 2024， 24（1）： 45.
[11] LITVAK Y， BYNDLOSS M X， TSOLIS R M， et al. Dysbiotic proteobacteria expansion： a microbial signature of epithelial dysfunction[J]. Curr Opin Microbiol， 2017， 39： 1-6.
[12] HAGHIKIA A， JORG S， DUSCHA A， et al. Dietary fatty acids directly impact central nervous system autoimmunity via the small intestine[J]. Immunity， 2016， 44（4）： 951-953.
[13] ZHANG Q， LU C， FAN W， et al. Application background and mechanism of short-chain fatty acids in sepsis-associated encephalopathy[J]. Front Cell Infect Microbiol， 2023， 13： 1137161.
[14] CHEN L， LI H， LI J， et al. Lactobacillus rhamnosus GG treatment improves intestinal permeability and modulates microbiota dysbiosis in an experimental model of sepsis[J]. Int J Mol Med， 2019， 43（3）： 1139-1148.
[15] AGUDELO-OCHOA G M， VALDES-DUQUE B E， GIRALDO-GIRALDO N A， et al. Gut microbiota profiles in critically ill patients， potential biomarkers and risk variables for sepsis[J]. Gut Microbes， 2020， 12（1）： 1707610.
[16] LIU W， CHENG M， LI J， et al. Classification of the gut microbiota of patients in intensive care units during development of sepsis and septic shock[J]. Genomics Proteomics Bioinformatics， 2020， 18（6）： 696-707.
[17] CHANG B T， WANG Y， TU W L， et al. Regulatory effects of mangiferin on LPS-induced inflammatory responses and intestinal flora imbalance during sepsis[J]. Food Sci Nutr， 2024， 12（3）： 2068-2080.
[18] CAI Y， DONG Y， HAN M， et al. Lacticaseibacillus paracasei LC86 mitigates age-related muscle wasting and cognitive impairment in SAMP8 mice through gut microbiota modulation and the regulation of serum inflammatory factors[J]. Front Nutr， 2024， 11： 1390433.

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备注/Memo

备注/Memo:
基金项目 吴阶平医学基金会临床科研专项资助基金（320.6750.2021-08-3）
作者简介 林玫秀 （1990-），女，主管护师，研究方向：重症医学；通信作者：张苏明，E-mail： samuel3766@126.com。
更新日期/Last Update: 2025-11-20