本文關(guān)鍵詞： 剖宮產(chǎn)術(shù) 正常分娩 嬰兒 腸道菌群　出處：《中國人民解放軍醫(yī)學(xué)院》2014年博士論文　論文類型：學(xué)位論文

【摘要】：目的：對比分析不同分娩方式出生嬰兒腸道菌群差異 方法：2012年4月至2012年11月在解放軍總醫(yī)院產(chǎn)科納入不同分娩方式（順產(chǎn)、剖宮產(chǎn)）的足月正常體重新生兒，收集胎糞及出生后1周、2周、1個月、2個月、3個月、6個月和1歲時糞便標(biāo)本凍存于-80oC冰箱。跟蹤隨訪嬰兒喂養(yǎng)、生長發(fā)育、腸道情況以及用藥情況（抗生素及益生菌制劑）。提取糞便細(xì)菌基因組DNA并擴(kuò)增其16S rDNA的V4區(qū)，應(yīng)用Illumina Miseq PE300平臺測序，分析其腸道菌群結(jié)構(gòu)。 結(jié)果：1.最終隨訪得到喂養(yǎng)方式為母乳和配方奶粉混合喂養(yǎng)、且出生后1年內(nèi)均未用過抗生素及益生菌制劑的嬰兒共21例，其中剖宮產(chǎn)嬰兒15例，順產(chǎn)嬰兒6例；2.胎糞中豐度最高的是變形菌門和硬壁菌門，其次是放線菌門和擬桿菌門，菌群組成以類桿菌屬、雙歧桿菌屬、梭菌屬、棲糞桿菌屬、鏈球菌屬和韋榮球菌屬為主；3.嬰兒出生后1年內(nèi)，順產(chǎn)組糞便樣本總體菌群多樣性略高于剖宮產(chǎn)組；順產(chǎn)組糞便樣本阿克曼菌屬和瘤胃球菌屬相對豐度高于剖宮產(chǎn)組；而剖宮產(chǎn)組糞便樣本中海桿菌屬和腸球菌屬相對豐度高于順產(chǎn)組；此外許多菌具有組間特異性，只出現(xiàn)于順產(chǎn)組或只出現(xiàn)于剖宮產(chǎn)組；4.在順產(chǎn)和剖宮產(chǎn)組各有幾例嬰兒其不同時間的糞便樣品可以通過Unweighted unifrac聚類分別各自聚合成一類。結(jié)論：胎糞中細(xì)菌種類豐富，嬰兒出生前腸道菌群已開始建立；順產(chǎn)嬰兒腸道菌群多樣性略高于剖宮產(chǎn)嬰兒，兩組嬰兒腸道菌群存在差異；嬰兒出生后腸道菌群不同時間點比較存在一致性。
[Abstract]:Objective: to compare and analyze the differences of intestinal flora in infants with different delivery modes. Methods: from April 2012 to November 2012, normal full-term newborns with normal weight were enrolled in obstetrics department of PLA General Hospital. Meconium was collected and meconium was collected at 1 week and 2 weeks after birth. Stool samples were frozen in -80oC refrigerator for 1 month, 2 months, 3 months, 6 months and 1 year old. Intestinal tract and drug use (antibiotics and probiotics). Genomic DNA of fecal bacteria was extracted and the V4 region of 16s rDNA was amplified. The structure of intestinal flora was analyzed by Illumina Miseq PE300. Results 1. At the end of follow-up, there were 21 infants who were not treated with antibiotics and probiotics within 1 year after birth, including 15 cases of caesarean section. 6 cases were born naturally; 2. The highest abundance of meconium was Proteus and phylum durum, followed by Actinomycetes and Bacteroides. The flora consisted of Bacteroides, Bifidobacterium, Clostridium, and faeconium. Streptococcus and Veronella were dominant. 3. Within 1 year after birth, the fecal microflora diversity in the normal delivery group was slightly higher than that in the caesarean section group. The relative abundance of Acemonium and Rumen coccus in the faecal samples of the normal delivery group was higher than that in the caesarean section group. The relative abundance of the faecal samples of Cesarean section group and Enterococcus group was higher than that of normal delivery group. In addition, many bacteria have inter-group specificity, only in the normal delivery group or only in the cesarean section group; 4. In the normal delivery and caesarean section groups, there were several infants whose fecal samples at different times could be clustered into one group by Unweighted unifrac. There are plenty of bacteria in meconium. The establishment of intestinal flora before the birth of infants; The diversity of intestinal flora was slightly higher than that of caesarean section, and there was a difference between the two groups. There was consistency in intestinal flora at different time points after birth.
【學(xué)位授予單位】：中國人民解放軍醫(yī)學(xué)院
【學(xué)位級別】：博士
【學(xué)位授予年份】：2014
【分類號】：R174

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