母乳喂养的新生儿病理性黄疸患儿肠道菌群结构变化观察  

Structural changes of intestinal flora in breast-fed newborns with pathological jaundice

作　　者：徐文秀 张楠[2] 邢雪雪 葛阳 李书玮 毕玫荣[2] XU Wenxiu;ZHANG Nan;XING Xuexue;GE Yang;LI Shuwei;BI Meirong(School of Clinical Medicine,Weifang Medical University,Weifang 261053,China;不详)

机构地区：[1]潍坊医学院临床医学院,山东潍坊261053 [2]济南市中心医院新生儿科

出　　处：《山东医药》2023年第30期39-43,共5页Shandong Medical Journal

摘　　要：目的 观察母乳喂养的新生儿病理性黄疸患儿肠道菌群结构变化,为新生儿病理性黄疸的辅助治疗提供理论依据。方法 选择30例母乳喂养的新生儿病理性黄疸患儿为观察组、30例健康新生儿为对照组。采集两组粪便标本,采用高通量16S rRNA基因测序技术检测两组粪便标本菌群RNA,采用β多样性及操作分类单元(operational taxonomic units,OTU)分析肠道菌群的多样性,采用LEfSe分析筛选优势肠道菌群(LDA score的绝对值>2),采用PICRUSt分析工具分析肠道菌群的生物学功能。结果 与对照组比较,观察组粪便肠道菌群在门、纲、目、科、属、种各水平上的细菌分类OTU数少(P均<0.05)。与对照组比较,观察组目水平上芽孢杆菌丰度低,属水平上柠檬酸杆菌丰度高、普拉梭菌丰度低,种水平上脆弱拟杆菌丰度低(P均<0.05)。观察组的优势肠道菌群为丁酸梭菌、鞘脂单胞菌及鞘氨单胞菌属,对照组影响力大的肠道菌群为脆弱拟杆菌、毛螺菌属。与对照组比较,观察组患儿参与矿质养分吸收、孢子形成、D-精氨酸和D-鸟氨酸代谢、聚酮糖单位生物合成功能通路的肠道菌群丰度低(P均<0.05)。粪便标本普拉梭菌及脆弱拟杆菌丰度与新生儿病理性黄疸患儿的血清总胆红素、间接胆红素水平呈负相关(P均<0.05)。结论 母乳喂养的新生儿病理性黄疸患儿存在肠道菌群结构失衡,患儿肠道菌群以普拉梭菌、脆弱拟杆菌为主。Objective To observe the structural changes of intestinal flora in breast-fed newborns with pathological jaundice and to provide the theoretical basis for the adjuvant treatment of neonatal pathological jaundice.Methods Thirty breastfeeding infants with pathological jaundice were selected as the observation group and 30 healthy newborns were selected as the control group.The fecal samples from two groups were collected.High-throughput 16S rRNA gene sequencing technology was used to detect RNA of fecal samples in the two groups,βdiversity and operational taxonomic units(OTU)were used to analyze the diversity of intestinal flora,and LEfSe was used to screen the dominant intestinal flora(absolute value of LDA score>2),and PICRUSt analysis tool was used to analyze the biological function of intestinal flora.Results Compared with the control group,the number of bacteria OUT in the phylum,class,order,family,genus,species levels was small(all P<0.05).Compared with the control group,Bacillus abundance was low at the order level,Citrobacter was high,Clostridium pratense was low at the genus level,and Bacaeroides fragilis was low at the species level(all P<0.05).The dominant intestinal flora of the observation group was Clostridium butyricum,sphingoliomonas and sphingomonas,while the influential intestinal flora of the control group were Bacteroides fragilis and Tricilis.Compared with the control group,the intestinal flora abundance involved in mineral nutrient absorption,spore formation,D-arginine and D-ornithine metabolism,and polyketose unit biosynthesis functional pathways were lower in the observation group(all P<0.05).The abundances of Clostridium pratense and Bacteroides fragilis were negatively correlated with serum total bilirubin and indirect bilirubin levels in children with neonatal pathological jaundice(all P<0.05).Conclusion There is structural imbalance and functional differences of intestinal flora in breast-fed newborns with pathological jaundice,and the intestinal flora of children are mainly Clostridium

关 键 词：新生儿黄疸 新生儿病理性黄疸 肠道菌群 芽孢杆菌 柠檬酸杆菌 普拉梭菌 脆弱拟杆菌 丁酸梭菌 

分 类 号：R722.17[医药卫生—儿科]