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鼻腔黏膜菌群多样性与慢性鼻窦炎发病及预后的相关性研究

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目的:分析鼻腔黏膜菌群多样性与慢性鼻窦炎发病及预后的相关性.方法:选取在本院收治的80例慢性鼻窦炎(CRS)患者作为研究组,同期本院收治的未合并鼻窦炎症的慢性泪囊炎、鼻中隔偏曲80例患者作为对照组,用鼻拭子在鼻内镜引导下采集受试者鼻分泌标本,行基质辅助激光解吸电离分型时间质谱分析、厌氧细菌培养及普通细菌培养,比较组间鼻腔黏膜菌群差异.对慢性鼻窦炎患者进行为期6个月的随访,再次采集患者鼻腔分泌物检测菌群,根据患者有无复发分为复发组(21例)和未复发组(59例).比较组间鼻腔菌属多样性.结果:2组术前疣微菌门、蓝藻菌门、绿湾菌门平均相对丰度(MRA)、卟啉单胞菌属、肠球菌属、梭杆菌属、未分类肠杆菌属、红球菌属、罗尔斯通菌属、埃希-志贺菌属、拟杆菌属及链球菌属MRA比较差异无统计学意义(P>0.05).研究组酸杆菌门、变形菌门、放线菌门MRA、莫拉克斯菌属、狡诈菌属、棒状杆菌属及葡萄球菌属MRA均明显低于对照组(P<0.05),梭杆菌门、拟杆菌门、厚壁菌门MRA、奈瑟菌属、假单胞菌属、嗜血杆菌属、乳酸菌属MRA明显高于对照组(P<0.05);复发组手术前后鼻腔菌群门、属水平MRA比较差异无统计学意义(P>0.05);非复发组术后拟杆菌属MRA高于术前(P<0.05),棒状杆菌属、放线菌门MRA明显低于术前(P<0.05),其他菌属、菌门MRA比较差异无统计学意义(P>0.05).结论:CRS的发病与鼻腔黏膜菌群失调有关,且术后菌群失调是否改善与患者预后相关性.
Correlation between nasal mucosal microbiota diversity and the pathogenesis and prognosis of chronic sinusitis
Objective:To analyze the correlation between nasal mucosal microbiota diversity and the pathogen-esis and prognosis of chronic sinusitis.Methods:A total of 80 patients with chronic sinusitis(CRS)admitted to Second Affiliated Hospital of Suzhou University were selected as the research group,and 80 patients with chronic dacryocystitis and nasal septum deviation without sinus inflammation admitted to our hospital during the same pe-riod were selected as the control group,nasal secretory specimens were collected under nasal endoscopic guidance by nasal swab,and matrix-assisted laser desorption ionization classification time mass spectrometry,anaerobic bacterial culture and common bacterial culture were performed to compare the differences in nasal mucosal flora between groups.Patients with chronic sinusitis were followed up for 6 months,and nasal secretions were collected again to detect microflora,and the patients were divided into relapse group(21 cases)and non-recurrence group(59 cases)according to whether the patients had relapse.Compare the diversity of nasal microbiota between groups.Results:There were no significant differences in mean relative abundance(MRA)between the two groups of pre-operative phylum Microbacterium verrucobacterium,Cyanobacterium phylum,Phylum Laubia mlaus,Porphy-romonas species,Enterococcus species,Fusobacterium species,Enterobacter species,Enterobacter species,Erythrobacterium species,Ralstonia species,Bacteroides and Streptococcus species(P>0.05).The MRA of Ac-idobacterium,Proteobacteria,Actinomycetes MRA,Moraxia,Cyanobacterium,Corynebacterium and Staphylo-coccus were significantly lower than those of the control group(P<0.05),and the MRA of Escher-Shigella spe-cies,Fusobacterium,Bacteroides,Firmicutes,Neisseria,Pseudomonas,Haemophilus and Lactobacillus was sig-nificantly higher than that of the control group(P<0.05),and there was no significant difference in MRA at the level of nasal flora and genus before and after surgery in the relapsed group(P>0.05).The MRA of Bacteroides after surgery was significantly lower in the non-recurrent group than that before surgery(P<0.05),the MRA of Corynebacterium and Actinomycetes was higher significantly than that of preoperative(P<0.05),and there was no significant difference in MRA of other species and phylum(P>0.05).Conclusion:The onset of CRS is related to nasal mucosal dysbacteria,and whether the dysbacteriosis improves after surgery is correlated with the prognosis of pa-tients.

chronic sinusitismicrobiota diversitynasal mucosaprognosisrelapse

李瀛、卫红齐、钱鸣涛

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苏州大学附属第二医院耳鼻咽喉科(江苏苏州,215004)

张家港市第一人民医院耳鼻咽喉科

慢性鼻窦炎 菌群多样性 鼻腔黏膜 预后 复发

2024

临床耳鼻咽喉头颈外科杂志
华中科技大学同济医学院附属协和医院

临床耳鼻咽喉头颈外科杂志

CSTPCD北大核心
影响因子:0.831
ISSN:1001-1781
年,卷(期):2024.38(12)