發(fā)布時(shí)間：2019-05-14 12:48

【摘要】：目的考察結(jié)腸癌根治術(shù)后腸道菌群與結(jié)腸癌預(yù)后的關(guān)系,以及益生菌干預(yù)對(duì)結(jié)腸癌預(yù)后的影響。方法收集2010年4月至2013年4月在我院收治并確診的Ⅱ期結(jié)腸癌患者185例,患者均接受根治術(shù),按照實(shí)際接受的治療方案分為益生菌干預(yù)組(80例)和益生菌未干預(yù)組(105例),選擇同期健康體檢者20例為對(duì)照組。收集術(shù)前和術(shù)后1個(gè)月糞便,采用熒光定量PCR檢測糞便的乳酸桿菌屬、雙歧桿菌屬、大腸桿菌和腸球菌屬。分析結(jié)腸癌患者術(shù)后4年生存情況及與腸道菌群數(shù)量的關(guān)系。結(jié)果兩組術(shù)前雙歧桿菌屬、乳酸桿菌屬、大腸桿菌和腸球菌屬差異無統(tǒng)計(jì)學(xué)意義(P0.05),根治術(shù)后,雙歧桿菌屬、乳酸桿菌屬、雙歧桿菌屬、大腸桿菌和腸球菌屬均明顯降低(P0.05),益生菌干預(yù)組和益生菌未干預(yù)組的菌群術(shù)前、術(shù)后差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。4年隨訪,無1例失訪。105例益生菌未干預(yù)組中存活90例(85.71%),15例(14.29%)死亡,其中14例為結(jié)腸癌轉(zhuǎn)移死亡,1例為心血管病死亡。乳酸桿菌屬(χ~2=6.700,P=0.035)和雙歧桿菌屬(χ~2=5.777,P=0.016)數(shù)量越高,大腸桿菌(χ~2=3.301,P=0.069)和腸球菌屬(χ~2=4.780,P=0.029)數(shù)量越低,結(jié)腸癌患者4年生存時(shí)間越長。80例益生菌干預(yù)組中存活76例(95.00%),4例(5.00%)患者死亡,其中3例為結(jié)腸癌轉(zhuǎn)移死亡,1例交通意外死亡。與益生菌未干預(yù)組比較,益生菌干預(yù)組的存活例數(shù)較多(χ~2=4.248,P=0.039),因結(jié)腸癌轉(zhuǎn)移死亡例數(shù)較少(χ~2=4.997,P=0.025)。結(jié)論結(jié)腸癌根治術(shù)后,雙歧桿菌屬和乳酸桿菌屬數(shù)量越高,大腸桿菌和腸球菌屬數(shù)量越低,結(jié)腸癌的預(yù)后較好。給予益生菌干預(yù)可明顯改善結(jié)腸癌根治術(shù)后患者的生存情況。
[Abstract]:Objective to investigate the relationship between intestinal flora and prognosis of colon cancer after radical resection of colon cancer, and the effect of probiotic intervention on prognosis of colon cancer. Methods 185 patients with stage II colon cancer admitted and diagnosed in our hospital from April 2010 to April 2013 were collected and divided into probiotics intervention group (80 cases) and probiotics non-intervention group (105 cases) according to the actual treatment plan. Twenty cases of healthy physical examination in the same period were selected as the control group. The feces were collected before and 1 month after operation, and Lactobacillus, bifidobacillus, Escherichia coli and Enterococcus were detected by fluorescence quantitative PCR. The survival rate of colon cancer patients at 4 years after operation and the relationship between survival and intestinal flora were analyzed. Results there was no significant difference in Bifidobacillus, Lactobacillus, Escherichia coli and Enterococcus between the two groups before operation (P 0.05). After radical operation, Bifidobacillus, Lactobacillus, Bifidobacillus, Escherichia coli and Enterococcus decreased significantly (P 0.05), and there was no significant difference between probiotics intervention group and probiotic non-intervention group before and after operation (P 0.05). 4 years follow-up, In 105 cases of probiotic unintervention group, 90 cases (85.71%) survived and 15 cases (14.29%) died, including 14 cases of colon cancer metastasis and 1 case of cardiovascular disease. The higher the number of Lactobacillus (蠂 ~ 2 鈮，

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