【作者】 雷毅；

【导师】 王昆华；

【作者基本信息】 昆明医科大学 ， 外科学， 2012， 硕士

【摘要】 第一部分：艾滋病患者肠道微生态的变化及规律研究目的观察艾滋病患者肠道微生态的变化,研究艾滋病对肠道微生态的影响,并初步探讨其相关机制。方法根据细菌的16S rRNA基因序列设计双歧杆菌属、乳酸杆菌属和大肠杆菌的特异性引物,根据细菌的ddl基因序列设计粪肠球菌及屎肠球菌的特异性引物。收集健康志愿者粪便标本30份(正常对照组)和艾滋病患者粪便标本30份(艾滋病患者组),提取细菌基因组DNA,应用SYBR Green I实时荧光定量PCR反应测定标本中5种细菌的数量,分析两组人群肠道微生态的差异。结果正常对照组与艾滋病患者组粪便中细菌数量分别为双歧杆菌属：9.17±1.29；5.75±1.54,乳酸杆菌属：8.03±1.23；5.04±1.04,与正常对照组相比较,艾滋病患者组数量明显减少(P<0.01)；大肠杆菌：4.67±0.80；7.59±1.24,粪肠球菌：4.56±0.87；6.09±1.08,屎肠球菌：5.10±0.92；9.48±0.73,艾滋病患者组数量明显增多,差异有统计学意义(P<0.05)。结论艾滋病患者肠道微生态发生了明显变化,提示艾滋病患者的肠道菌群失调,微生态紊乱。第二部分：辣木复合肠内营养对艾滋病患者肠道微生态的影响目的观察辣木复合肠内营养治疗前后艾滋病患者肠道微生态的变化,研究辣木对艾滋病患者肠道微生态的影响。为临床治疗艾滋病及其感染等并发症提供新的理论依据。方法将艾滋病患者随机分为营养治疗组(包括普通肠内营养组、辣木组和辣木复合肠内营养组)和对照组,分别给予普通肠内营养、辣木粉、辣木复合肠内营养治疗,对照组根据患者饮食习惯自主进食。于营养治疗后2周、4周收集患者粪便标本,提取细菌基因组DNA,应用SYBR GreenI实时荧光定量PCR反应测定5种细菌的数量,并进行组间比较。结果4周后营养治疗组较对照组双歧杆菌属和乳酸杆菌属增多(P<0.05),辣木复合肠内营养组较辣木组和普通营养增多更加明显(P<0.05)；营养治疗组较对照组大肠杆菌、粪肠球菌和屎肠球菌数量明显减少(P<0.01),辣木复合肠内营养组较普通营养降低更加明显(P<0.05)。结论辣木复合肠内营养能显著升高艾滋病患者肠道益生菌,拮抗肠道机会致病菌,对艾滋病患者肠道微生态有显著改善作用。更多还原

【Abstract】 Part ⅠResearch on the change of intestinal microecology in AIDSObjective To analysize the change of Acquired Immune Deficiency Syndrome (AIDS) patients’ intestinal microecology which helps explore the influence of AIDS to intestinal microflora, and to explore its mechanism.Methods Collected the feces of patients with AIDS (n=30) and healthy volunteers (n=30). A set of16S rRNA gene group of species-specific primers for Bifidobacterium spp., Lactobacillus group, Escherichia coli, and ddl gene-targeted species-specific primers for Enterococcus faecalis and feces Enterococcus were designed. Bacterial genome DNA extracted from fecal samples were quantified by SYBR Green Ⅰ real-time fluorescence quantitative PCR to analyze bacterial amounts, analysis the difference of the two groups of gut microflora.Results The level of Bifidobacterium spp.(9.17±1.29vs.5.75±1.54) and Lactobacillus group (8.03±1.23vs.5.04±1.04) in AIDS group were significantly lower than those of healthy control group, whereas Escherichia coli (4.67±0.80vs.7.59±1.24), Enterococcus faecalis(4.56±0.87vs.6.09±1.08) and feces Enterococcus (5.10±0.92vs.9.48±0.73) were significantly higher than those of healthy control group, There was significant difference (P<0.05).Conclusion The intestinal microflora of AIDS patients have obviously changed.These data underline that the intestinal microflora of AIDS patients is confusion. Part IIThe change of AIDS patients’intestinal microecology before and after the treatment of Morigna composite enteral nutritionObjective To analysize the Acquired Immune Deficiency Syndrome(AIDS) patients’intestinal microflora before and after the treatment of Morigna composite enteral nutrition which helps explore the influence of Morigna composite enteral nutrition to AIDS patients’intestinal microflora. To provide a new theoretical basis for the clinical treatment of AIDS infection and other complications.Methods The AIDS patients were randomly divided into nutrition treatment group(include common enteral nutrition group、 Morigna group and Morigna composite enteral nutrition group) and control group, separately collected the feces of patients after nutrition treatment for2weeks and4weeks. Bacterial genome DNA extracted from fecal samples were quantified by SYBR Green I real-time fluorescence quantitative PCR to analyze bacterial amounts.Results After the nutrition treatment for4weeks, the Bifidobacterium spp.,and Lactobacillus in nutrition treatment group were significantly higher than those of control group(P<0.05), the Bifidobacterium spp.,and Lactobacillus in Morigna composite enteral nutrition group were significantly higher than those of Morigna group and in common enteral nutrition group(P<0.05); the Escherichia coli, Enterococcus faecalis and feces Enterococcus in nutrition treatment group were significantly lower than those of control group (P<0.01), in Morigna composite enteral nutrition group were significantly lower than those of in common enteral nutrition group(P<0.05).Conclusion Morigna composite enteral nutrition have a significant affect on rise of AIDS patients’intestinal probiotics, antagonist intestinal opportunity pathogenic bacteria, significantly ameliorate the AIDS patients’intestinal microflora.更多还原