多发伤患者早期肠道菌群及其代谢产物氧化三甲胺的变化OACSTPCD

Objective:Patients with multiple trauma have poor prognosis once complicated with sepsis and multiple organ dysfunction syndrome.This study aims to explore the possible mechanism of sepsis and multiple organ dysfunction syndrome in patients with multiple trauma by observing the early changes in gut microbiota and its metabolite trimethylamine oxide. Methods:Twenty-five patients with multiple trauma who met the inclusion criteria were selected from Affiliated Hospital of Jiangsu University from April 2023 to September 2023 as a multiple trauma group.Concurrently,25 healthy volunteers who met the inclusion criteria were selected from the Physical Examination Center of Affiliated Hospital of Jiangsu University as a control group.Stool and plasma samples were collected from the multiple trauma group approximately 1 week after injury and on the same day of physical examination from the control group.The stool samples were analyzed using 16S rRNA high-throughput sequencing technology to analyze the differences in gut microbiota between the multiple trauma group and the control group.The plasma samples were analyzed using high-performance liquid chromatography-tandem mass spectrometry to assess the differences in plasma trimethylamine oxide levels between the 2 groups. Results:There were significant differences in the gut microbiota composition between the multiple trauma group and the control group.At the phylum level,the relative abundance of Proteobacteria was significantly higher in the multiple trauma group compared to the control group(P<0.05),while the relative abundance of Firmicutes and Bacteroidetes was significantly lower in the multiple trauma group(P<0.05).At the genus level,the relative abundance of Escherichia Coli,Pathogenic Enterococcus,Fusobacterium and Phascolarctobacterium was significantly higher in the multiple trauma group(all P<0.05),whereas the relative abundance of Prevotella,Bifidobacteria,Rumen Bacteria,Lactobacillus,Faecalis,Brautella and Butyrivibrio was significantly lower in the multiple trauma group(all P<0.05).Plasma trimethylamine oxide level was significantly higher in the multiple trauma group compared to the control group(P<0.05). Conclusion:Compared to healthy individuals,patients with multiple trauma exhibit early changes in gut microbiota,characterized by a decrease in the relative abundance of obligate anaerobes and beneficial commensals,and an increase in the relative abundance of facultative anaerobes and opportunistic pathogens.These changes may be related to the development of sepsis in patients with multiple trauma.Additionally,the elevated plasma trimethylamine oxide may be related to the alterations in gut microbiota and the development of multiple organ dysfunction syndrome in these patients.