Effect of enteral nutrition on the intestinal microbiome and risk of death in ischemic stroke patients
Effect of enteral nutrition on the intestinal microbiome and risk of death in ischemic stroke patients
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DOI：
10.1002/jpen.2370
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发表时间：
2022
影响因子：
3.4
通讯作者：
Wei Song
中科院分区：
文献类型：
--
作者：
Xiaolin Tian;Genghong Xia;Mingsi Zhang;Chuhong Tan;Mengjia Yang;Huidi Wang;Xinna Song;Shiqi Chai;Jia Yin;Wei Song
研究背景研究表明，脑卒中患者的肠道微生物群发生显著改变，微生物群紊乱的程度与预后相关。肠内营养（EN）可以重塑肠道微生物组，对伴有吞咽困难的卒中患者非常重要。我们的目的是描述肠道菌群在缺血性脑梗死患者接受标准EN.MethodsFirst，17名健康对照（HC），54例脑卒中患者口服喂养（ON），和50例脑卒中患者EN相匹配，调查肠道菌群的变化与EN入院后第一周和EN组在第二周的动态变化。其次，我们研究了接受EN的参与者（n= 147）的更大样本中肠道微生物组与临床特征之间的关系。采用考克斯比例风险回归进行生存分析。肠道菌群的组成和结构进行了分析，通过16S rRNA sequencing.ResultsCompared HC和ON组，EN患者表现出显着不同的肠道菌群的组成，在第一周，包括富集的机会致病菌肠球菌和消耗的细菌，如毛螺菌科，和瘤胃球菌，这是在第二周进一步耗尽。ParvimasandComamonas丰度的增加与180天死亡率的增加相关。结论接受EN的缺血性卒中患者的肠道微生物群显著改变，特定菌株的细菌可能与预后和临床指标相关。
BackgroundStudies have shown that the intestinal microbiome of stroke patients is significantly altered and that the degree of microbiota disturbance correlates with prognosis. Enteral nutrition (EN) can reshape the intestinal microbiome and is important for stroke patients with dysphagia. We aimed to describe the intestinal microbiome in patients with ischemic cerebral infarction receiving standard EN.MethodsFirst, 17 healthy controls (HCs), 54 stroke patients with oral feeding (ON), and 50 stroke patients with EN were matched to investigate the changes in the intestinal microbiota with EN in the first week after admission and dynamic changes in the EN group in the second week. Second, we investigated the relationship between the intestinal microbiome and clinical characteristics in a larger sample of participants receiving EN (n= 147). Survival analysis was performed using Cox proportional hazards regression. The composition and structure of the intestinal microbiota were analyzed by 16S rRNA sequencing.ResultsCompared with the HC and ON groups, patients with EN exhibited significantly different compositions of the intestinal microbiota in the first week, including enrichment of the opportunistic pathogenEnterococcusand depletion of bacteria such asLachnospiraceae, andRuminococcus, which were further depleted in the second week. An increase inParvimonasandComamonasabundances was associated with an increased risk of 180‐day mortality.ConclusionsThe intestinal microbiota in ischemic stroke patients receiving EN is significantly altered, and specific strains of bacteria may be associated with prognosis and clinical indicators.