4~6岁阻塞性睡眠呼吸暂停低通气综合征患儿肠道菌群特征及手术干预前后肠道菌群的变化分析  

Characteristics of gut microbiota in children aged 4-6 years with obstructive sleep apnea hypopnea syndrome and changes in intestinal bacteria before and after surgical intervention

作　　者：王婷[1] 吴军华[2] Wang Ting;Wu Junhua(Health Science Center,Ningbo University,Ningbo 315211,China;Department of Paediatrics,Ningbo Women and Children′s Hospital,Ningbo 315000,China)

机构地区：[1]宁波大学医学部,宁波315211 [2]宁波市妇女儿童医院儿科,宁波315000

出　　处：《中华微生物学和免疫学杂志》2024年第12期1028-1036,共9页Chinese Journal of Microbiology and Immunology

基　　金：宁波市第一批医疗卫生高端团队重大攻坚项目(2022020405);宁波市重点学科儿科学(2022-B17);宁波市公益重点项目(2021S100);浙江省医药卫生面上项目(2021KY1056)。

摘　　要：目的探究阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患儿肠道菌群特征及手术干预前后肠道菌群的变化。方法选取104例确诊为OSAHS的4~6岁患儿作为实验组,选取90例排除OSAHS的同年龄段健康儿童为对照组,收集粪便标本。随机选取接受手术干预的42例患儿,收集手术前、手术后半个月、手术后1个月粪便标本。对所有粪便标本进行肠道菌群16S rRNA高通量测序,分析肠道细菌特征及手术干预对4~6岁OSAHS患儿肠道菌群变化的影响。结果 OSAHS组患儿肠道菌群有效序列增多,α多样性降低;肠道菌门无显著差异,肠道菌属之间具有显著差异,OSAHS患儿中另枝菌属、巨单胞菌属、多尔氏菌属、瘤胃球菌属、巴内西氏菌属、苏黎世杆菌属和粪球菌属相对丰度降低,黄曲霉属、梭状芽孢杆菌属ⅩⅧ群、梭状芽孢杆菌属Ⅳ群、肠球菌属升高。手术干预后1个月内OSAHS患儿肠道菌群有效序列、OTU、Shannon指数和手术前后有差异的菌属中83.3%(5/6)具有朝向对照组水平恢复的趋势。结论 4~6岁OSAHS患儿肠道菌群具有自身特征;手术干预前后肠道菌群发生改变,手术干预有助于促进OSAHS患儿肠道菌群的恢复。ObjectiveTo investigate the characteristics of intestinal bacteria in children with obstructive sleep apnea hypopnea syndrome(OSAHS)and the changes of intestinal bacteria before and after operative treatment.MethodsA total of 104 children aged 4-6 years diagnosed with OSAHS by polysomnography were selected as the experimental group,while 90 healthy children of the same age excluded from OSAHS were selected as the control group,which had no snoring,mouth breathing,sleep disorders,and other manifestations.Stool specimens were collected from both study groups.Forty-two children who underwent surgical treatment were randomly selected,and their fecal samples were collected before the surgery,half a month after the surgery,and one month after the surgery.High-throughput 16S rRNA sequencing was performed on all fecal specimens to analyze the characteristics of intestinal bacteria and the effects of surgical intervention on the changes of intestinal flora in children aged 4-6 years with OSAHS.ResultsCompared with the control group,the number of valid sequences of intestinal flora in children in the OSAHS group increased,while theα-diversity decreased.No significant difference in relative abundance was observed between the two groups at the phylum level,but there was significant difference at the genus level.The children in the OSAHS group had lower abundance of the genera Alistipes,Megamonas,Dorea,Ruminococcus,Barnesiella,Turicibacter,and Coprococcus,but higher abundance of the genera Flavonifractor,Clostridium_ⅩⅧ,Clostridium_Ⅳ,and Enterococcus.One month after the operative treatment,the valid sequences,OUT,Shannon diversity index and 83.3%(5/6)of the genera that differed before and after surgery exhibited a trend towards recovering to the levels in the control group.ConclusionsThe intestinal bacteria in OSAHS children aged 4-6 years have distinct characteristics and can be influenced by surgical intervention.This study suggests that surgical intervention can promote the recovery of intestinal bacteria in children

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 儿童 肠道菌群 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]