肠道菌群丰度与病理性黄疸新生儿临床指标的相关性及诊断价值分析  

Analysis of the correlation and diagnostic value of gut microbiota abundance with clinical indicators in neonates with pathological jaundice

作　　者：左群 郁西平 高科 李志飞[1] Zuo Qun;Yu Xi-ping;Gao ke;Li Zhi-fei(Department of Neonatology,The First Affiliated Hospital of Ningbo University,Ningbo,Zhejiang 315020,China)

机构地区：[1]宁波大学附属第一医院新生儿科,浙江宁波315020

出　　处：《中国现代医学杂志》2024年第15期1-6,共6页China Journal of Modern Medicine

基　　金：浙江省医药卫生科技计划项目(No:2023RC310)。

摘　　要：目的探讨病理性黄疸新生儿与健康新生儿肠道菌群丰度的差异及其与临床指标的相关性,评估肠道菌群丰度在病理性黄疸新生儿诊断中的价值。方法选取2022年9月—2023年6月宁波大学附属第一医院新生儿科收治的60例病理性黄疸新生儿为黄疸组,选取同期在该院体检的健康新生儿80例作为对照组。收集两组新生儿一般资料并采集静脉血进行临床检测。采集两组新生儿粪便并使用高通量16S rRNA基因测序技术检测两组新生儿粪便样本中菌群RNA,分析肠道菌群α多样性[Chao指数、Shannon指数、Simpson指数],采用Pearson法分析临床指标与健康、病理性黄疸新生儿肠道菌群失调的相关性。采用受试者工作特征(ROC)曲线分析新生儿肠道菌群丰度与临床指标对病理性黄疸的诊断价值。结果黄疸组高敏C反应蛋白(hs-CRP)、一氧化碳血红蛋白(CoHb)、白细胞计数(WBC)、血红蛋白浓度(HGB)、红细胞压积(HCT)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(γGT)、总胆红素(TBIL)、直接胆红素(DBIL)水平均高于对照组(P<0.05)。两组新生儿红细胞计数(RBC)、中性粒细胞计数(NE)、血红蛋白(Hb)、血小板计数(PLT)、血小板压积(PCT)比较,差异均无统计学意义(P>0.05)。两组新生儿肠道菌群Shannon指数、Simpson指数、Chao指数比较,差异均无统计学意义(P>0.05)。黄疸组普拉梭菌属、柠檬酸杆菌属丰度高于对照组(P<0.05)。两组新生儿肠道埃希菌属、葡萄球菌属、克雷伯菌属、双歧杆菌属丰度比较,差异均无统计学意义(P>0.05)。Pearson相关性分析显示,病理性黄疸组新生儿hs-CRP、CoHb、WBC、ALT、γGT、TBIL、DBIL水平与肠道菌群普拉梭菌属呈正相关(r=0.280、0.330、0.375、0.160、0.229、0.470和0.449,均P<0.05),HGB、HCT、AST与肠道菌群普拉梭菌属无相关性(r=0.161、0.091和0.074,均P>0.05)。hs-CRP、CoHb、WBC、HGB、ALT�Objective To investigate the differences in gut microbiota abundance between neonates with pathological jaundice and healthy neonates,explore the correlation between gut microbiota and clinical indicators,and evaluate the diagnostic value of gut microbiota abundance in neonatal pathological jaundice.Methods Sixty neonates with pathological jaundice admitted to the Department of Neonatology at the Affiliated First Hospital of Ningbo University from September 2022 to June 2023 were included in the jaundice group,while eighty healthy neonates undergoing physical examination during the same period were selected as the control group.General data were collected from both groups,and venous blood was sampled for clinical testing.Fecal samples were collected,and high-throughput 16S rRNA gene sequencing was performed to analyze the RNA of gut microbiota.Theα-diversity of gut microbiota was assessed using Chao,Shannon,and Simpson indices.The correlation between clinical indicators and gut microbiota dysbiosis in both healthy and jaundiced neonates was analyzed using Pearson correlation.The diagnostic value of gut microbiota abundance and clinical indicators for pathological jaundice was assessed using Receiver Operating Characteristic(ROC)curves.Results The jaundice group showed significantly higher levels of high-sensitivity C-reactive protein(hs-CRP),carboxyhemoglobin(CoHb),white blood cell count(WBC),hemoglobin concentration(HGB),hematocrit(HCT),alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-glutamyl transpeptidase(γGT),total bilirubin(TBIL),and direct bilirubin(DBIL)compared to the control group(P<0.05).There were no statistically significant differences in red blood cell count(rBC),neutrophil count(NE),hemoglobin(Hb),platelet count(PLT),or plateletcrit(PCT)between the two groups(P>0.05).The Shannon,Simpson,and Chao indices of gut microbiota did not differ significantly between the two groups(P>0.05).The abundance of Clostridium and Citrobacter was higher in the jaundice group compared to the control

关 键 词：病理性黄疸 肠道菌群丰度 新生儿 诊断价值 受试者工作特征曲线 

分 类 号：R722.17[医药卫生—儿科]