先天性巨结肠患儿术后肠炎相关肠道菌群特征与功能分析  

Characteristics and function analysis of intestinal flora associated with postoperative enteritis in children with Hirschsprung disease

作　　者：伍美[1] 牛会忠[1] 张鹏举[1] 刘锋[1] 贺新建[2] 赵丹[1] 臧艳秋 张治广 苏利波 Wu Mei;Niu Huizhong;Zhang Pengju;Liu Feng;He Xinjian;Zhao Dan;Zang Yanqiu;Zhang Zhiguang;Su Libo(First Department of General Surgery,Hebei Children's Hospital,Shijiazhuang 050031,China;Department of Ultrasound,Hebei Children's Hospital,Shijiazhuang 050031,China;Hebei Key Laboratory of Animal Science,Department of Laboratory Animals,Hebei Medical University,Shijiazhuang 050017,China)

机构地区：[1]河北省儿童医院普外一科,石家庄050031 [2]河北省儿童医院超声科,石家庄050031 [3]河北省实验动物学重点实验室,河北医科大学实验动物学部,石家庄050017

出　　处：《中华小儿外科杂志》2025年第1期44-51,共8页Chinese Journal of Pediatric Surgery

基　　金：国家自然科学基金面上项目(32270563);河北省卫生健康委员会医学科学研究课题计划项目(20200216,20231111);河北自然科学基金精准医学联合基金(H2022206405)。

摘　　要：目的比较先天性巨结肠术后发生肠炎与术后未发生肠炎患儿肠道菌群组成与差异,探明与先天性巨结肠术后肠炎发生相关的关键菌群。方法选取2019年4月至2020年12月于河北省儿童医院就诊的19例先天性巨结肠患儿作为研究对象,根据患儿术后2个月至1年是否发生肠炎进行分组,发生肠炎为肠炎组(7例),未发生肠炎为对照组(12例)。收集各组患儿随访时粪便后,构建文库并利用高通量测序方式对细菌16S rRNA基因进行测序,利用QIIME2流程对测序数据进行分析,对两组患儿肠道菌群组成、多样性、差异菌群、菌群物种间相关性以及菌群与疾病之间联系进行分析,探讨先天性巨结肠患儿术后肠炎的肠道菌群特点。结果肠炎组患儿与对照组肠道菌群组成物种差异较大;肠炎组患儿厌氧小杆菌属、劳特尔菌属、梭状芽孢杆菌属无毒组、厌氧球菌属、瘤胃球菌属、Akk菌属等菌群显著增多。经多级物种差异判别分析发现肠炎组患儿Muri菌科、鞘氨醇单胞菌、α-变形菌纲、代尔夫特菌属、拟杆菌目、伯克菌科、β-变形菌纲等菌群显著减少。结合临床指标分析,发现伯克霍尔德菌属、链球菌属、肠杆菌属、双歧杆菌属、梭属目等菌属与先天性巨结肠术后肠道稳态维持关联较大,真杆菌属、克雷伯菌属、大肠志贺菌属、肠杆菌属等菌属增多与术后肠炎发生有密切联系。结论先天性巨结肠术后肠炎患儿与无肠炎患儿相比,肠道菌群组成及β多样性方面存在差异;伯克霍尔德菌属、链球菌属、肠球菌属、双歧杆菌属等菌属的减少以及真杆菌属、克雷伯菌属、大肠志贺菌属、梭菌目、肠杆菌属等菌属增多与先天性巨结肠术后肠炎存在显著关联。Objective To compare and analyze the composition and difference of gut microbiota between children with Hirschsprung disease(HSCR)who do or do not develop postoperative enteritis,and to explore the key gut microbiota related to the occurrence of postoperative enteritis.MethodsA prospective study was conducted involving 19 HSCR children who visited Hebei Children's Hospital from April 2019 to December 2020.Nineteen HSCR children were stratified into two groups based on the occurrence of enterocolitis from 2 months to 1 year post-surgery:the enterocolitis group(n=7)and the control group(n=12).Stool samples were collected from both groups.Following library construction,high-throughput sequencing of bacterial 16S rRNA genes was performed.Sequencing data were analyzed using the quantitative insights into microbial ecology 2(QIIME2)pipeline to evaluate gut microbiota composition,diversity indices,differential abundance analysis,inter-species correlations,and microbiota-disease associations to characterize the intestinal microbiome in postoperative enterocolitis.ResultsSignificant taxonomic differences were observed between groups.The enterocolitis group showed significant abundances in the Bacteroides,Raoultella,Clostridium innocuum group,Anaerococcus,Ruminococcus,and Akkermansia.Linear discriminant analysis effect size(LefSe)analysis revealed significantly declined abundances in the Muribaculaceae,Sphingomonadaceae,Alphaproteobacteria,Delftia,Bacteroidales,Burkholderiaceae,and Betaproteobacteria in enterocolitis patients.Integration with clinical parameters demonstrated strong associations between postoperative enterocolitis and alterations in the abudnances of Eubacterium,Burkholderia,Streptococcus,Klebsiella,Escherichia-Shigella,and Enterobacter.ConclusionsPostoperative enterocolitis in Hirschsprung disease is characterized by distinct alterations in gut microbiota composition and beta diversity.The primary microbial signature is the decline of key bacterial taxa.Specifically,decreased abundances of Burkholderia,Str

关 键 词：先天性巨结肠 肠道菌群 基因测序 

分 类 号：R726.5[医药卫生—儿科]