Study On The Correlation Between Abdominal Microecology And Intestinal Microecology In Acute Pancreatitis

This study was divided into four parts: risk factor analysis of AP complicated with pancreatic infection,gut microbiota analysis of AP,correlation of intraperitoneal microecology and intestinal microecology of INP and analysis of intestinal flora of different TCM syndromes.1.Risk factors and pathogen analysis of patients in AP complicated with pancreatic infection.Objective: Analysis of pathogen characteristics,infection time and risk factors in patients with pancreatic infection.Methods: The clinical datum of 286 patients with MSAP and SAP from January 2016 to August 2019 in Tianjin Nankai Hospital were collected,and the risk factors of secondary infection were investigated.Results:Patients were divided into non-infectious groups(n=163)and infected groups(n=123)according to the presence of pancreatic infection.Logistics regression analysis showed that MCTSI,extend of pancreatic necrosis,TPN use,extrapancreatic infection,HCT,and CRP were risk factors in AP with infection complication(P<0.05).Conclusion: MCTSI,extend of pancreatic necrosis,extrapancreatic infection,TPN use,HCT,and CRP are risk factors in AP with pancreatic infection.2.Gut microbiota characteristics in patients with APObjective: Explore the gut microbiota changes and correlation with Clinical characteristics in AP by 16 Sr DNA sequencing.Methods: 37 patients with AP who met the inclusion criteria and 20 healthy volunteers were included in study.All the participants were divided into healthy group,MAP group and SAP group,and the differences of gut microbiota between the three groups were compared.Intestinal microbial information detection were completed by 16 Sr DNA high-throughput sequencing technology.Results: Compared with healthy volunteers,gut microbial diversity and richness decreased,intestinal dominant bacteria decreased and pathogen bacteria abundance increased in AP.With the change of disease severity,the abundance of pathogenic bacteria increased.Conclusion: Gut microbial diversity and richness decreased,intestinal dominant bacteria decreased,pathogen and conditional pathogenic bacteria abundance increased in patients with AP.3.Relationship between abdominal microecology and intestinal microecology in INPObjective: Observe the gut microbiota changes in INP at different stages,homology characteristics of pancreatic necrotic tissue flora and gut microbiota,and recovery time of gut microbiota.Methods: 5 patients with INP from april 2019 to december 2019 were prospectively observed.Fecal samples and pancreatic necrotic tissue from onset to discharge were collected.Compared the 16 Sr DNA sequencing information of pancreatic necrotic tissue with the culture reports in our hospital.Observe the changes of gut microbiota at different time stages and predict the recovery time of intestinal function.Results: The pancreatic necrotic tissue flora was similar to the gut microbiota,and the culture results of peripancreatic drainage fluid were similar to those of 16 Sr DNA sequencing.The gut microbiota began to recover after 7 weeks of onset.Conclusion: The necrotic tissue microorganisms are similar to the gut microbiota.The gut microbiota began to recover after 7 weeks of onset,but when to return to normal state still needs further observation.4.Effects of different TCM syndromes and Qingyi decoction on gut microbiota in patients with AP.Objective: Observe the difference of gut microbiota in different TCM patterns and the effect of early Qing Yi decoction on intestinal barrier in AP.Methods: Patients were divided into three different TCM syndrome groups,and the differences of gut microbiota between different groups were analyzed.Effect of early Qingyi decoction on intestinal microorganism in AP was observed prospectively.Results: The dominant flora of patients with different TCM syndromes is similar,but the abundance of flora is different.Early treatment of Qingyi decoction can effectively improve the clinical symptoms of patients with AP.Conclusion: The dominant flora of patients with different TCM syndromes is similar,but the abundance of flora is different.Treatment of Qingyi decoction in early stage can improve the function of intestinal barrier,and accelerate the recovery of disease.