| Background and Objective:There are a large number of hepatitis patients in China.The number of deaths due to cirrhosis after hepatitis has increased year by year.Among them,upper gastrointestinal bleeding caused by portal hypertension is an important cause of death.At present,the most commonly used surgical treatment method for patients with post-hepatic cirrhosis and portal hypertension is splenectomy combined with pericardial vascular dissection.However,the incidence of thrombosis in the portal vein system is high after surgery,which seriously affects the prognosis of patients,and may even endanger patients' lives if they are not handled properly.At present,anticoagulant therapy is mainly used for portal vein thrombosis in clinical practice,but the incidence of thrombosis cannot be completely reduced,and the related mechanism is still unclear and cannot meet clinical needs.Many studies at home and abroad have shown that the intestinal microecology is involved in certain specific pathways of thrombotic events.We intend to use this as an entry point and compare the intestinal microecology of patients with or without thrombosis in the portal vein by Illumina Hiseq Changes in the composition and function of the drug,looking for microbial components and potential pathways that play a key role in it,so as to provide new ideas and targets for clinical prevention and treatment.It also provides reference for later research.Method:We collected fecal samples from 7 patients with portal vein thrombosis after splenectomy(thrombosis group)and 8 patients without portal vein thrombosis after splenectomy(non-thrombosis group)as the research subjects for metagenomic sequencing analysis.Methods such as Principal Co-ordinates Analysis(PCoA),Venn diagrams,analysis of differences between groups,linear discriminant analysis and effect factor analysis(LEf Se),metabolic pathway analysis,and species contribution analysis were performed to elucidating the changes in intestinal microecological structure and function of patients with portal vein thrombosis after laparoscopic splenectomy from multiple levels.Result:1.The results of Principal Co-ordinates Analysis(PCoA)showed that the two groups of samples had a clear trend of separation,indicating that the intestinal microecology in the two groups of samples had significant differences in the overall composition and structure.Further analysis by ADONIS showed that the differences in intestinalmicroecological composition and structure between the two groups are statistically significant,indicating that the results of this test are highly credible(P<0.05).2.Venn diagram analysis showed that there were 1273 species of the same microorganisms in the two groups,199 species were unique in the thrombus group,and343 species were unique in the non-thrombotic group.There are 6947 kinds of metabolic pathways in the two groups,8148 kinds in the thrombosis group which included 1201 kinds of unique metabolic pathways,7355 kinds in the non-thrombotic group which included 408 kinds of unique metabolic pathways.There were differences in the species content and the number of metabolic pathways between the thrombus group and the non-thrombotic group(P <0.05).3.The high-abundance mycoplasma(relative abundance >1%)in the two groups were mainly in Firmicutes,Proteobacteria,Bacteroides,and Actinomycota.The highest content is the Firmicutes.At the genus level,Bacteroides,Lactobacillus,Clostridium,Prevotella,Parabacteroides,Ruminococcus,Streptococcus,Alistipes,Escherichia,Eubacterium,Enterococcus,had higher abundances in each sample(relative abundance >1%).4.Analysis of differences between groups showed no statistical difference between the two groups at the phylum level.At the genus level,there were 22 species with statistically significant differences in the two groups.Clostridium and Escherichia were higher in the thrombus group than in the non-thrombotic group,and the remaining 20 species were lower than the non-thrombotic group(P <0.05).5.The LEf Se analysis showed that the key flora in the intestine of patients in the thrombosis group was mainly in the Ascomycota.The key flora in the intestinal of patients in the non-thrombotic group was mainly in Proteobacteria.6.The metabolic pathways with higher abundance in the two groups are mainly focused on carbohydrate metabolism,global and overview maps,amino acid metabolism,membrane transport,and nucleosides acid metabolism.7.In a comparative analysis of the functional metabolism of the stool samples of the two groups,we found that there were 31 metabolic pathways with statistical differences between the two groups,of which 9 functional metabolisms were higher in the thrombus group than in the non-thrombotic group,which were Etherlipid metabolism,Renal cell carcinoma,Glycerolipid metabolism,Two-component system,Ascorbate and aldarate metabolism,Lysine degradation,Pentose phosphate pathway,Chagas disease,Prion diseases.The remaining 22 functional metabolisms were lower in the thrombus group than in the non-thrombotic group(P <0.05).8.Through the analysis of the contribution of the main different functional species,we found that Bacteroides,Lactobacillus,Parabacillus,Streptococcus,Eubacteria,Clostridium all made important contributions.Among them,Bacteroides contributed the most.Conclusion:1.The intestinal micro-ecological diversity of patients in the thrombosis group changed,mainly as Clostridium,Escherichia increased and Bacteroides decreased..2.The functional metabolism in the intestinal tract of patients in the thrombosis groupchanged,mainly manifested by increased sugar breakdown,enhanced lipid metabolism,and altered amino acid metabolism..3.Significant changes in the intestinal microecological structure and functional metabolism of patients in the thrombosis group.This experiment has initially explored the changes in the intestinal microecology of patients with postoperative portal vein thrombosis,which provided new ideas and targets for the pathogenesis and clinical prevention of portal vein thrombosis after operation.It also provides reference for further research. |
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