探究直肠癌患者术后肠道菌群变化与抑郁症的关系。

选取2022年1月至2023年8月行直肠癌根治术术后并发抑郁症的57例患者为观察组，选取同期行直肠癌根治术术后未发生抑郁症的43例为对照组。采用软件SPSS 22.0完成数据分析。肠道菌群丰度等计量资料用（）表示，行独立样本t检验；肠道菌群紊乱占比等计数资料比较用[例（%）]表示，行χ²检验；Logistic多因素分析直肠癌术后抑郁症发生的危险因素；Pearson相关性分析肠道菌群与汉密尔顿抑郁量表（HAMD）评分的关系。P<0.05为差异有统计学意义。

观察组患者失眠人数占比、白细胞介素6（IL-6）、C反应蛋白（CRP）水平显著高于对照组（P<0.05）；观察组患者菌群失调Ⅰ度占比、厚壁菌门丰度、Chao1指数、Shannon指数显著低于对照组，拟杆菌门、变形菌门、放线菌门丰度及菌群失调Ⅱ度占比显著高于对照组，差异有统计学意义（P<0.05）；多因素Logistic回归分析结果显示，失眠、肠道菌群失调Ⅱ度、厚壁菌门丰度减少、拟杆菌门丰度升高、变形菌门丰度升高、放线菌门丰度升高、Chao1指数和Shannon指数降低是影响直肠癌患者术后抑郁症发生独立危险因素（P<0.05）；Pearson相关性分析显示，HAMD评分与拟杆菌门、变形菌门、放线菌门呈显著正相关（P<0.05），与厚壁菌门、Chao1指数、Shannon指数呈显著负相关（P<0.05）。

直肠癌患者术后肠道拟杆菌门、变形菌门、放线菌门丰度升高，厚壁菌门丰度降低及肠道菌群丰富度和多样性减少与抑郁症的发生有关，是影响抑郁症发生的独立危险因素。

To explore the relationship between postoperative intestinal flora and depression in patients with rectal cancer.

Fifty-seven patients with depression after radical resection of rectal cancer from January 2022 to August 2023 were selected as the observation group, and 43 patients without depression after radical resection of rectal cancer during the same period were selected as the control group. SPSS 22.0 software was used to complete data analysis. The equal measurement data of intestinal flora abundance in the two groups were represented by () and independent t test was performed. The equal measurement data of intestinal flora disturbance ratio between the two groups were compared by [cases (%)], and χ² test was performed. Logistic multivariate analysis of the risk factors of postoperative depression in rectal cancer; The relationship between intestinal flora and Hamilton Depression Scale (HAMD) score was analyzed by Pearson correlation. P<0.05 was statistically significant.

The proportion of insomnia, the levels of interleukin-6 (IL-6) and C-reactive protein (CRP) in observation group were significantly higher than those in control group (P<0.05). The proportion of flora disorder Ⅰ, abundance of firmicutes, Chao1 index and Shannon index in observation group were significantly lower than those in control group, while the abundance of Bacteroidetes, Proteobacteria and actinobacteria and the proportion of flora disorder Ⅱ were significantly higher than those in control group, with statistical significance (P<0.05). Multivariate Logistic regression analysis showed that insomnia, degree Ⅱ of intestinal flora imbalance, decreased abundance of firmicutes, increased abundance of Bacteroidetes, increased abundance of Proteobacteria, increased abundance of actinobacteria, and decreased Chao1 index and Shannon index were independent risk factors for postoperative depression in rectal cancer patients (P<0.05). Pearson correlation analysis showed that HAMD score was significantly positively correlated with Bacteroidetes, Proteobacteria and actinobacteria (P<0.05), and significantly negatively correlated with Firmicutes, Chao1 index and Shannon index (P<0.05).

The increased abundance of Bacteroides, Proteobacteria and actinomycetes, the decreased abundance of firmicutes and the decreased richness and diversity of intestinal flora in postoperative patients with rectal cancer are related to the occurrence of depression, and are independent risk factors affecting the occurrence of depression.