肠道特异性菌群联合肝脏硬度声触诊弹性成像和声触诊弹性测量在儿童胆汁淤积性肝炎中的应用价值  

Application value of gut-specific microbiota combined with STE and STQ liver stiffness assessment in intrahepatic cholestasis of childhood

作　　者：董蕾 赖赣萍 卜丹 黄亮 周玉琴 DONG Lei;LAI Ganping;BU Dan;HUANG Liang;ZHOU Yuqin(Department of Ultrasound Medicine,Ganzhou Maternal and Child Health Hospital,Ganzhou,Jiangxi 341000,China;不详)

机构地区：[1]赣州市妇幼保健院超声医学科,江西341000 [2]赣州市妇幼保健院儿童感染及肾内科

出　　处：《中国微生态学杂志》2025年第2期222-227,共6页Chinese Journal of Microecology

基　　金：江西省卫生健康委科技计划(202312037)。

摘　　要：目的探讨肠道特异性菌群特征联合肝脏硬度声触诊弹性成像(STE)和声触诊弹性测量(STQ)在儿童胆汁淤积性肝炎(ICH)诊断中的应用价值,为该类患者的治疗提供参考。方法纳入2022年1月至2024年1月我院确诊的96例ICH患儿为ICH组,选择同期我院50例健康儿童为对照组。收集两组对象粪便样本并进行16S rRNA基因高通量测序,比较ICH组与对照组儿童肠道菌群的alpha多样性差异和菌群丰度差异。所有患儿均接受STE及STQ测量肝脏硬度参数(LSM)评估肝纤维化程度。采用受试者工作特征曲线(ROC)分析肠道菌群、STE和STQ对ICH的诊断效能。结果ICH组患儿的肠道菌群丰度(Chao1指数)显著低于对照组(P<0.05),且肠球菌属(Enterococcus)、链球菌属(Streptococcus)及肠杆菌属(Enterobacter)的相对丰度显著升高,双歧杆菌属(Bifidobacterium)的丰度显著下降(均P<0.05)。具有显著肝纤维化的患儿LSM的STE和STQ评分均显著高于无显著肝纤维化的患儿(均P<0.05)。ROC分析表明,肠道特异菌群丰度联合STE和STQ对ICH的诊断效能优于单一检测(AUC=0.943,95%CI:0.902~0.983,P<0.001)。结论肠道特异性菌群联合STE和STQ在评估儿童ICH方面展现出较高的临床应用潜力,有望作为ICH无创诊断的有力辅助工具。Objective To explore the diagnostic value of gut microbiota characteristics specific to intestine,combined with liver stiffness elastography(STE)and transient elastography(STQ)in the diagnosis of intrahepatic cholestasis of childhood(ICH),and provide a reference for the treatment of the patients.Methods A total of 96 pediatric patients diagnosed with ICH between January 2022 and January 2024 were included in the ICH group,while 50 healthy children were selected as the control group.Fecal samples from both groups were collected and subjected to 16S rRNA gene highthroughput sequencing.The differences in the alpha diversity and microbial abundance of gut microbiota between the ICH group and control group were compared.All the children underwent STE and STQ measurements to assess liver stiffness parameters(LSM)for evaluating the degree of liver fibrosis.The diagnostic performance of gut microbiota,STE and STQ for ICH were analyzed using receiver operating characteristic(ROC)curves.Results The gut microbiota abundance(Chao1 index)in the ICH group was significantly lower than that in the control group(P<0.05).The relative abundance of Enterococcus,Streptococcus and Enterobacter were significantly higher,while that of Bifidobacterium was significantly lower in the ICH group(all P<0.05).The children with significant liver fibrosis had significantly higher STE and STQ scores(LSM)than those without significant liver fibrosis(all P<0.05).ROC analysis showed that the combination of gut microbiota abundance,STE and STQ had a superior diagnostic efficacy for ICH compared to single tests(AUC=0.943,95%CI:0.902-0.983,P<0.001).Conclusion The combination of gut microbiota characteristics specific to intestine,STE and STQ demonstrates high clinical potential for evaluating pediatric ICH,and may serve as a powerful non-invasive diagnostic tool for ICH.

关 键 词：胆汁淤积性肝炎 肠道菌群 声触诊弹性成像 声触诊弹性测量 

分 类 号：R575.2[医药卫生—消化系统]