幽门螺杆菌感染对十二指肠溃疡患儿十二指肠球部黏膜菌群的影响  

The effect of Helicobacter pylori infection on duodenal bulbar microbiota in children with duodenal ulcer

作　　者：郑伟 彭克荣[1] 李甫棒[1] 赵泓[1] 江米足[2] Zheng Wei;Peng Kerong;Li Fubang;Zhao Hong;Jiang Mizu(Department of Gastroenterology,Children′s Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,National Children′s Regional Medical Center,Hangzhou 310052,China;Department of Gastroenterology and Pediatric Endoscopy Center,Children′s Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,National Children′s Regional Medical Center,Hangzhou 310052,China)

机构地区：[1]浙江大学医学院附属儿童医院消化科、国家儿童健康与疾病临床医学研究中心、国家儿童区域医疗中心,杭州310052 [2]浙江大学医学院附属儿童医院消化科和儿童内镜中心、国家儿童健康与疾病临床医学研究中心、国家儿童区域医疗中心,杭州310052

出　　处：《中华儿科杂志》2023年第1期49-55,共7页Chinese Journal of Pediatrics

基　　金：浙江省重点研发计划(2021C03064);浙江省卫生健康科技计划(2022KY869)。

摘　　要：目的探讨幽门螺杆菌(Hp)感染对十二指肠溃疡患儿十二指肠球部黏膜菌群的影响。方法前瞻性队列研究。以2018年1至8月在浙江大学医学院附属儿童医院因腹痛、腹胀、呕吐等症状就诊并经胃镜检查确诊为十二指肠溃疡的23例患儿为研究对象, 根据有无Hp感染分为Hp阳性溃疡组和Hp阴性溃疡组。提取十二指肠球部黏膜DNA, 行高通量测序分析。比较分析两组样品α多样性差异、β多样性差异及其在各分类水平丰度变化情况, 利用PICRUSt软件预测微生物功能。组间比较采用t检验、秩和检验或χ^(2)检验。结果 23例十二指肠溃疡患儿中Hp阳性溃疡组15例[年龄(11.2±3.3)岁, 男11例、女4例]、Hp阴性溃疡组8例[年龄(10.1±4.4)岁, 男6例、女2例]。Hp阳性溃疡组螺杆菌属丰度明显高于Hp阴性溃疡组[0.551%(0.258%, 5.368%)比0.143%(0.039%, 0.762%), Z=2.00, P=0.045], 而梭状杆菌属、链球菌属及丛毛单胞菌科的一个未分类菌属丰度均明显低于Hp阴性溃疡组[0.010%(0.001%, 0.031%)比0.049%(0.011%, 0.310%), Z=-2.24, P=0.025;0.031%(0.015%, 0.092%)比0.118%(0.046%, 0.410%), Z=-2.10, P=0.036;0.046%(0.036%, 0.062%)比0.110%(0.045%, 0.176%), Z=-2.01, P=0.045]。线性判别效应值显示在属水平Hp阳性溃疡组十二指肠球部黏膜菌群只有螺杆菌属显著富集[线性判别分析(LDA)=4.89, P=0.045], 而Hp阴性溃疡组链球菌属及梭状杆菌属显著富集(LDA=3.28、3.11, P=0.036、0.025)。PICRUSt菌群功能预测分析发现, Hp阳性溃疡组球部黏膜菌群氧化磷酸化、疾病相关通路(肿瘤、肾细胞癌、阿米巴病及1型糖尿病)等多个通路的表达均明显高于Hp阴性溃疡组(均P<0.05), 而能量代谢、磷酸转移酶系统等通路表达均明显低于Hp阴性溃疡组(均P<0.05)。结论 Hp感染十二指肠溃疡患儿十二指肠球部黏膜菌群发生了改变, 主要是螺杆菌属丰度显著升高, 而梭状杆菌属、链球菌属丰度下降, 并可能通过�Objective To investigate the characteristics of duodenal bulbar microbiota in children with duodenal ulcer and Helicobacter pylori(Hp)infection.Methods This prospective cohort study enrolled 23 children with duodenal ulcers diagnosed by gastroscopy who were admitted to the Children′s Hospital of Zhejiang University School of Medicine due to abdominal pain,abdominal distension,and vomiting from January 2018 to August 2018.They were divided into Hp-positive and Hp-negative groups according to the presence or absence of Hp infection.Duodenal bulbar mucosa was sampled to detect the bacterial DNA by high-throughput sequencing.The statistical difference inαdiversity andβdiversity,and the relative abundance in taxonomic level between the two groups were compared.Microbial functions were predicted using the software PICRUSt.T-test,Rank sum test orχ^(2) test were used for comparison between the two groups.Results A total of 23 children diagnosed with duodenal ulcer were enrolled in this study,including 15 cases with Hp infection((11.2±3.3)years of age,11 males and 4 females)and 8 cases without Hp infection((10.1±4.4)years of age,6 males and 2 females).Compared with Hp-negative group,the Hp-positive group had higher Helicobacter abundance(0.551%(0.258%,5.368%)vs.0.143%(0.039%,0.762%),Z=2.00,P=0.045)and lower abundance of Fusobacterium,Streptococcus and unclassified-Comamonadaceae(0.010%(0.001%,0.031%)vs.0.049%(0.011%,0.310%),Z=-2.24,P=0.025;0.031%(0.015%,0.092%)vs.0.118%(0.046%,0.410%),Z=-2.10,P=0.036;0.046%(0.036%,0.062%)vs.0.110%(0.045%,0.176%),Z=-2.01,P=0.045).Linear discriminant analysis(LDA)effect sized showed that at the genus level,only Helicobacter was significantly enriched in Hp-positive group(LDA=4.89,P=0.045),while Streptococcus and Fusobacterium significantly enriched in Hp-negative group(LDA=3.28,3.11;P=0.036,0.025,respectively).PICRUSt microbial function prediction showed that the expression of oxidative phosphorylation and disease-related pathways(pathways in cancer,renal cell carcinoma,amoebiasis,ty

关 键 词：螺杆菌 幽门 十二指肠溃疡 儿童 肠黏膜 

分 类 号：R725.7[医药卫生—儿科]