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目的研究成年肺囊性纤维化(cystic fibrosis,CF)患者1年内呼吸道菌群的变化特点。方法收集9例已确诊的CF患者痰液标本,平均每月1次,共1年,同时记录患者一般临床状态。对痰液标本分别进行传统细菌培养和16S rRNA测序确定样本中的菌种。根据基因测序确定的菌种结果分析患者1年内呼吸道菌群的变化特点,及其可能与患者的临床状态间的关系。结果通过非培养方法检测到的菌种和临床状态之间无显著相关性。研究初期发现的菌种数量和后续新菌种的获得率之间没有显著关系(所有患者的成对皮尔森相关,P=0.631,r2=0.5)。反Bray-Curtis相似性指数评估在12月内群落组成的总体变化,CF患者之间细菌菌群的变化是不同的,每个患者菌群平均丰度与其时间的变化间无相关性(皮尔森相关P=0.252,R=0.389)。采用DDR检测样本间的相似性是否完全由于样本收集间的时间间隔造成,结果显示1个受试者的距离衰减关系差异有统计学意义(患者5,P=0.041),其他受试者的结果两个采样点的菌落组成与采样的时间间隔没有显著关系,这表明上述观察到的菌落稳定性并非是一个简单的采样频率函数。结论成年CF患者的呼吸道菌群尽管彼此有差异,但各自的长期定植菌群构成相对稳定,不易受呼吸道感染和抗生素应用的影响。
Objective To study the changes of respiratory flora in adult patients with cystic fibrosis (CF) within one year. Methods Nine sputum samples of CF patients were collected and averaged once a month for a total of 1 year. The clinical status of patients was also recorded. Sputum samples were subjected to conventional bacterial culture and 16S rRNA sequencing to determine the species in the sample. According to the results of the bacterial strains determined by sequencing, the characteristics of respiratory tract flora in patients within one year were analyzed, and their relationship with the clinical status of the patients may be analyzed. Results There was no significant correlation between the strains detected by the non-culture method and the clinical status. There was no significant relationship between the number of species found early in the study and the subsequent acquisition of new species (paired Pearson correlation for all patients, P = 0.631, r2 = 0.5). The anti-Bray-Curtis similarity index assesses the overall change in community composition over the 12 months, with changes in bacterial flora differing among patients with CF, and there is no correlation between average abundance in each patient and changes in their time (Pearson Correlation P = 0.252, R = 0.389). Using DDR to test whether the similarity between samples was entirely due to the time interval between sample collection showed a statistically significant difference in distance attenuation for one subject (Patient 5, P = 0.041) and results for other subjects The colony composition of the two sampling points is not significantly related to the sampling interval, indicating that the observed colony stability is not a simple sampling frequency function. Conclusion Although the respiratory flora of adult CF patients are different from each other, their long-term colonization flora is relatively stable and not susceptible to respiratory infection and antibiotic application.