目的 探讨肠内营养治疗对缺血性脑卒中患者肠道微生态的影响。 方法 2017年3月至4月，121例恢复期缺血性脑卒中患者，在常规康复的基础上，予肠内营养治疗1周。入院时、干预后1周和1个月时分别留取新鲜粪便和血浆，记录患者营养状况。酶联免疫吸附试验检测肿瘤坏死因子-α (TNF-α)、白细胞介素(IL)-1α、IL-1β、IL-6和IL-8，选10例患者行16S rDNA基因序列检测。 结果 干预后1个月，患者营养风险筛查量表评分较入院时降低(P < 0.05)；血清IL-1β和IL-6水平较入院时升高(P < 0.05)，而血清IL-8水平较入院时下降(P < 0.05)。此外，肠内营养治疗可改变肠道的优势菌群，提高菌群多样性和丰度。 结论 肠内营养可通过改变缺血性脑卒中患者肠道菌群来调节炎症因子水平。
Objective To explore the effect of enteral nutrition on gut microbiota for ischemic stroke. Methods From March to April, 2017, 121 patients with convalescent ischemic stroke were enrolled. The patients received routine rehabilitation combing with 1-week enteral nutrition. The patients' fresh feces and blood samples were obtained at admission, one week and one month after the enteral nutrition, while nutritional status was assessed with Nutrition Risk Screening (NRS2002). Cytokines, including tumor necrosis factor (TNF) -α, interleukin (IL)-1α, IL-1β, IL-6 and IL-8 were tested with ELISA. Ten patients were tested with 16S rDNA Illumina HiSeq/MiSeq for gut microbiota alterations. Results The scores of NRS2002 decreased (P < 0.05), the level of serum IL-1β and IL-6 raised, while the level of IL-8 dropped one month after enteral nutrition (P < 0.05). In addition, the enteral nutrition altered the dominant bacterial community, and alleviated the diversity and species richness of bacteria, while the difference was statistically significant one week after enteral nutrition. Conclusion Enteral nutrition can alter gut microbiota to facilitate to recover ischemic stroke.
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