早中期早产儿喂养不耐受肠道菌群特征研究  

Characteristics of the intestinal flora of feeding intolerance in early and middle preterm infants

作　　者：傅春燕 许景林[1,2] 王赫 陈冬梅 Fu Chunyan;Xu Jinglin;Wang He;Chen Dongmei(The Graduate School of Fujian Medical University,Fuzhou 350001;Department of Neonatology,Quanzhou Women's and Children's Hospital,Quanzhou 362000)

机构地区：[1]福建医科大学研究生院,福建福州350001 [2]泉州市妇幼保健院·儿童医院新生儿科,福建泉州362000

出　　处：《中国现代医药杂志》2025年第3期27-36,共10页Modern Medicine Journal of China

基　　金：泉州市2021年医疗卫生领域指导性科技计划项目(编号:2021N096S);华侨大学联合创新基金项目(编号:2023YX002)。

摘　　要：目的了解早中期喂养不耐受(Feeding intolerance,FI)早产儿的肠道菌群分布特征,为不同胎龄早产儿FI的早期防治提供精准指导。方法采用前瞻性研究方法,以2021年12月~2022年12月我院新生儿科住院、出生胎龄28~34周FI早产儿为研究对象,其中胎龄<32周为早期早产儿FI组(EFI组),胎龄32~34周为中期早产儿FI组(MFI组)。收集两组患儿FI症状发生24h内(急性期)及FI缓解后24h内(恢复期)的粪便标本,通过16S rRNA高通量测序,进行肠道菌群操作性分类单元(Operational Taxonomic Units,OTU)聚类统计、多样性、构成及差异性分析。结果共纳入胎龄28~34周FI早产儿40例,其中EFI组和MFI组各20例,收集FI急性期及恢复期粪便样本共80份。EFI组与MFI组急性期肠道菌群OTUs个数无明显差异,EFI组与MFI急性期OTUs个数均高于恢复期;EFI组与MFI组急性期肠道菌群群落组成存在差异,而恢复期肠道菌群群落组成相似;早中期早产儿FI急性期Alpha多样性指数Chao1及Shannon值均高于恢复期。在细菌门水平上,主要菌群种类相同,但在相对丰度较少的特异菌种占比存在差异。对关键菌群差异分析发现,早中期不同胎龄早产儿FI的差异菌群主要为韦荣氏菌属(LDA=4.035,P=0.035)、狭义梭菌属(LDA=4.501,P=0.035)、柠檬酸杆菌属(LDA=3.974,P=0.023);早期早产儿FI急性期梭菌属(LDA=3.980,P=0.006)的相对丰度显著高于恢复期,而中期早产儿FI急性期狭义梭菌属(LDA=4.512,P=0.005)的相对丰度显著高于恢复期。结论韦荣氏球菌属、狭义梭菌属、柠檬酸杆菌属是造成早中期不同胎龄FI肠道菌群差异的主要类群,早中期不同胎龄早产儿FI症状缓解时梭菌属丰度均下降,但不同胎龄下降的梭菌属种类有差异。Objective To investigate the distribution characteristics of intestinal flora in preterm infants with feeding intolerance(FI)in the early and middle stages,and to provide precise guidance for the early prevention and treatment of FI in preterm infants of different gestational ages.Methods A prospective study was conducted on preterm infants with FI aged 28~34 weeks admitted to the neonatal department of our hospital from Dec 2021 to Dec 2022.Infants with a gestational age of less than 32 weeks were assigned to the early preterm FI group(EFI group),while those with a gestational age of 32~34 weeks were assigned to the middle preterm FI group(MFI group).Fecal samples were collected from the two groups within 24 hours of the onset of FI symptoms(acute phase)and within 24 hours after the resolution of FI symptoms(recovery phase).The samples were subjected to 16S rRNA high-throughput sequencing for analysis of intestinal microbiota,including OTU clustering statistics,diversity assessment,compositional profiling,and differential analysis.Results A total of 40 preterm infants with FI aged 28~34 weeks were included,with 20 infants in each of the EFI and MFI groups,and a total of 80 fecal samples were collected during the acute and recovery phases of FI.There was no significant difference in the number of OTUs in the gut microbiota between the EFI and MFI groups during the acute phase.However,the OTU counts in both the EFI and MFI groups during the acute phase were higher than those in the recovery phase.The composition of gut microbiota communities differed between the EFI and MFI groups during the acute phase but was similar during the recovery phase.The Alpha diversity indices,including the Chao1 and Shannon values,were higher in the early and middle preterm infants during the acute phase of FI than in the recovery phase.At the phylum level,the main bacterial taxa were the same,but differences were observed in the proportions of specific taxa with lower relative abundance.Key microbiota difference analysis revealed tha

关 键 词：胎龄 早产儿 肠道菌群 16S rRNA 喂养不耐受 

分 类 号：R72[医药卫生—儿科]