【摘要】 目的研究肾移植术后排斥患者肠道菌群变化的特点。方法比较肾移植术后排斥患者及未排斥患者肠道菌群的变化,分析肠道菌群与肾移植排斥反应的相关性;以肾功能相关指标:肌酐(Scr)、尿素(BUN)、胱抑素C(Cys-C)、移植肾超声、移植肾穿刺活检评估肾脏移植患者排斥反应状态;检测患者淋巴细胞对供者骨髓源性树突状细胞(DC)刺激的反应,评价肾移植术后患者的免疫反应功能。结果肾移植术后,排斥患者粪便中类杆菌含量[(5.53±0.74)CFU/g]明显少于未排斥患者[(6.84±1.66)CFU/g](P<0.05);双歧杆菌数量、肠球菌数量与肾移植患者尿素水平相关(r=-0.482,P=0.027;r=0.439,P=0.046);类杆菌数量与肾移植患者尿素、肌酐、胱抑素C相关(r=-0.457,P=0.037;r=-0.515,P=0.014;r=-0.463,P=0.035)。排斥组患者的淋巴细胞对供者骨髓源性树突状细胞刺激的强度显著高于未排斥组(P<0.05)。结论肾移植术后排斥反应患者肠道菌群发生了显著改变,并与肾功能指标密切相关,此发现为合理应用抗排异药物、抗生素以及微生态制剂提供了理论依据,或可为减轻移植排斥提供新的思路和手段。更多还原

【Abstract】 Objective To research the changes in the intestinal flora of patients with kidney transplant rejection.Methods The correlation between intestinal flora and kidney transplant rejection were analyzed. Six species of intestinal bacteria were detected in the patients with and without kidney transplant rejection respectively. SCr,BUN,Cys-C,Duplex Doppler and renal biopsy were used to evaluate the severity of the rejection. The responses of recipients’ lymphoeytes to donor’s DCs were measured to analyze the immune function after renal transplantation. Results The number of fecal Bacteroides [( 5. 53 ± 0. 74) CFU / g] was significantly less in patients with kidney transplantation rejection than in those without rejection [( 6. 84 ± 1. 66) CFU / g]( P < 0. 05).; The numbers of Bifidobacterium and Enterococcus were associated with BUN content in patients accepted kidney transplantation( r =- 0. 482,P = 0. 027; r = 0. 439,P = 0. 046). Bacteroides number was associated with BUN,SCr and,Cys-C in kidney transplant patients( r =- 0. 457,P = 0. 037; r =- 0. 515,P = 0. 014; r =- 0. 463,P = 0. 035). The responses of lymphocytes to donor ’s DCs were stronger in patients with rejection than in those without rejection( P < 0. 05). Conclusion Intestinal flora of kidney transplant rejection patients would alter after kidney transplant and is closely associated with renal function indexes. This finding may guide antibiotic or microbioecologics therapy regimens and provide new perspectives for reducing the risk of graft rejection.更多还原