肺炎支原体肺炎患儿肠道菌群和粪便免疫因子分析  

Analysis of gut microbiota and fecal immune factors in children with Mycoplasma pneumoniae pneumonia

作　　者：胡津津 张晓英 Hu Jinjin;Zhang Xiaoying(Department of Pediatrics,Ninth People′s Hospital Affiliated to Shanghai JiaoTong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院儿科,上海200011

出　　处：《中华微生物学和免疫学杂志》2024年第10期838-852,共15页Chinese Journal of Microbiology and Immunology

摘　　要：目的探讨不同临床分型肺炎支原体肺炎(MPP)患儿肠道菌群和粪便裂解液免疫因子差异。方法选取2023年3月—2024年2月上海第九人民医院住院的3~14岁MPP患儿,依据病情严重程度分为轻症组(GMPP组)和重症组(SMPP组),根据治疗反应分为非难治组(NRMPP组)和难治组(RMPP组);采用16S rRNA测序分析肠道菌群特征,采用MSD电化学发光法测定粪便裂解液免疫因子水平;分析比较MPP患儿的临床特征、肠道菌群、粪便免疫因子差异;Spearman法进行相关性分析;受试者工作特征(ROC)曲线分析肠道菌群对MPP临床分型的评估和预测价值。结果64例MPP患儿中GMPP组34例,SMPP组30例,两组在热程、有无低氧血症、C-反应蛋白(CRP)、D-二聚体、胸部CT评分等方面差异有统计学意义(t=-4.49,P<0.001;χ^(2)=5.33,P=0.021;z=-2.93,P=0.003;z=-3.93,P<0.001;z=-4.10,P<0.001)。64例MPP患儿中NRMPP组50例,RMPP组14例,两组比较年龄、热程、胸部CT评分差异有统计学意义(t=-3.21,P=0.002;t=-5.28,P<0.001;z=-2.95,P=0.003)。GMPP组和SMPP组之间肠道菌群Alpha多样性分析差异无统计学意义(P>0.05);两组肠道菌群Beta多样性分析差异有统计学意义(R2=0.06,P=0.001);物种差异分析显示,SMPP组双歧杆菌属(Bifidobacterium)相对丰度较GMPP组明显降低,布劳特菌属(Blautia)、活泼瘤胃球菌(Ruminococcus gnavus)相对丰度较GMPP组明显升高,差异有统计学意义(z=5.21,P<0.001,Q=0.039;z=1.56,P<0.001,Q=0.039;z=2.08,P=0.007,Q=0.700)。NRMPP组和RMPP组之间肠道菌群Alpha多样性分析差异无统计学意义(P>0.05);两组肠道菌群Beta多样性分析差异有统计学意义(R2=0.05,P=0.001);物种差异分析显示,RMPP组双歧杆菌属、罕见小球菌属(Subdoligranulum)相对丰度较NRMPP组明显降低,布劳特菌属、活泼瘤胃球菌相对丰度较NRMPP组明显升高,差异有统计学意义(z=3.44,P=0.012,Q=0.638;z=3.64,P=0.040,Q=0.638;z=5.80,P=0.001,Q=0.338;z=5.46,P=0.015,Q=0.638)。GMPP组和SMPP组之间ObjectiveTo explore the differences in gut microbiota and immune factors in fecal lysate of children with different clinical subtypes of Mycoplasma pneumoniae pneumonia(MPP).MethodsChildren aged 3-14 years with MPP who visited Shanghai Ninth People′s Hospital from March 2023 to February 2024 were selected and divided into general group(GMPP group)and severe group(SMPP group)based on the severity of the condition.They were also divided into non-refractory group(NRMPP group)and refractory group(RMPP group)based on treatment response.16S rRNA sequencing was used to analyze the characteristics of gut microbiota,and MSD electrochemiluminescence method was used to determine the levels of immune factors in fecal lysate.Differences in the clinical characteristics,gut microbiota,and fecal immune factors were analyzed.Spearman correlation analysis was performed.Receiver operating characteristic(ROC)curve was used to analyze the evaluation and predictive value of gut microbiota in clinical classification of MPP.ResultsAmong the 64 children with MPP,there were 34 cases in the GMPP group and 30 cases in the SMPP group.There were statistically significant differences between the two groups in terms of fever duration,presence or absence of hypoxemia,C-reactive protein(CRP),D-Dimer,and chest CT scores(t=-4.94,P<0.001;χ^(2)=5.33,P=0.021;z=-2.93,P=0.003;z=-3.93,P<0.001;z=-4.10,P<0.001).Among the 64 children with MPP,there were 50 cases in the NRMPP group and 14 cases in the RMPP group.There were statistically significant differences in age,fever duration,and chest CT scores between the two groups(t=-3.21,P=0.002;t=-5.28,P<0.001;z=-2.95,P=0.003).There was no statistically significant difference in the alpha diversity analysis of gut microbiota between GMPP group and SMPP group(P>0.05).There was a statistically significant difference in beta diversity analysis between the two groups of gut microbiota(R 2=0.06,P=0.001).Species difference analysis showed that the relative abundance of Bifidobacterium in the SMPP group was significa

关 键 词：肺炎支原体肺炎 肠道菌群 免疫因子 布劳特菌属 双歧杆菌属 

分 类 号：R725.6[医药卫生—儿科]