儿童抽动障碍患者肠道菌群分布特点及其与病情严重程度的关系  

Characteristics of gut microbiota distribution in children with tic disorder and its relationship with disease severity

作　　者：李希 何道卫 郑明平 董菲艳 陈竞建 王晶晶 陈向坚 卓晓峰 刘学锋 LI Xi;HE Daowei;ZHENG Mingping;DONG Feiyan;CHEN Jingjian;WANG Jingjing;CHEN Xiangjian;ZHUO Xiaofeng;LIU Xuefeng(Department of Pediatrics,Ningde City Hospital Affiliated to Ningde Normal University,Ningde,Fujian 352100,China;不详)

机构地区：[1]宁德师范学院附属宁德市医院儿科,宁德352100 [2]屏南县医院儿科

出　　处：《中国微生态学杂志》2025年第3期331-336,344,共7页Chinese Journal of Microecology

基　　金：2022年度宁德市自然科学基金联合项目(2022J10)。

摘　　要：目的 探讨儿童抽动障碍(TD)患者肠道菌群分布特点及其与病情严重程度的关系,为该类患者的治疗提供参考。方法 选取2022年11月至2024年6月我院收治的120例TD患儿作为研究对象,收集患儿临床资料,依据耶鲁综合抽动严重程度量表(YGTSS)评分将TD患儿分为轻中度TD组(n=79)和重度TD组(n=41)。比较两组患儿临床资料,采用二元Logistic回归分析影响儿童重度TD发生的危险因素,采用受试者工作曲线(ROC)分析肠道菌群分布特点对儿童重度TD发生的预测作用。结果 两组患儿性别、年龄、BMI、出生胎龄、出生体质量、出生疾病史、病程、常住地、家庭平均月收入、家族抽动障碍史及家族精神疾病史比较差异均无统计学意义(均P>0.05)。重度TD组患儿混合性抽动、主要照料者文化程度为高中及以下的占比高于轻中度TD组,肠道双歧杆菌、乳杆菌数量低于轻中度TD组,大肠埃希菌、乳状瘤胃球菌、粪杆菌数量高于轻中度TD组(均P<0.05)。二元Logistic回归分析显示,较高的大肠埃希菌、乳状瘤胃球菌、粪杆菌数量是影响重度TD发生的危险因素(均P<0.05)。ROC分析显示,大肠埃希菌数量预测重度TD发生的最佳截断点为6.909 lg CFU/g,AUC为0.831;乳状瘤胃球菌水平预测重度TD发生的最佳截断点为8.874 lg CFU/g,AUC为0.868;粪杆菌水平预测重度TD发生的最佳截断点为7.589 lg CFU/g,AUC为0.823;三者联合检测AUC为0.967。结论 较高的大肠埃希菌、乳状瘤胃球菌、粪杆菌数量是影响儿童重度TD发生的危险因素。大肠埃希菌、乳状瘤胃球菌及粪杆菌水平对儿童重度TD的发生具有较高的预测评估作用,且联合预测价值更高。Objective To observe the characteristics of gut microbiota distribution in children with tic disorder(TD) and its relationship with the disease severity,providing a reference for the treatment.Methods A total of 120 children with TD admitted to our hospital between November 2022 and June 2024 were enrolled as the subjects.The clinical data of these patients were collected,and based on the Yale Global Tic Severity Scale(YGTSS) scores,the patients were divided into mild-to-moderate TD group(n=79) and severe TD group(n=41).The clinical data between the two groups were compared.Binary Logistic regression analysis was conducted to identify the risk factors for severe TD in children.Receiver operating characteristic curve(ROC) analysis was employed to assess the predictive value of distribution characteristics of gut microbiota for the occurrence of severe TD in children.Results There were no statistically significant differences between the two groups in terms of gender,age,BMI,gestational age at birth,birth weight,history of neonatal diseases,duration of illness,place of permanent residence,average monthly household income,family history of TD,and family history of psychiatric disorders(all P>0.05).The severe TD group had a higher proportion of mixed tics and primary caregivers with an education level of high school or below compared to the mild-to-moderate TD group.Additionally,the counts of Bifidobacterium and Lactobacillus were lower,while the levels of Escherichia coli,Ruminococcus lactaris and Coprococcus were higher in the severe TD group than in the mild-to-moderate TD group(all P<0.05).Binary Logistic regression analysis revealed that high counts of Escherichia coli,Ruminococcus lactaris and Coprococcus were the risk factors for occurrence of severe TD(all P<0.05).ROC analysis showed that the optimal cutoff point for Escherichia coli counts to predict severe TD was 6.909 lg CFU/g,with an AUC of 0.831;for Ruminococcus lactaris,it was 8.874 lg CFU/g,with an AUC of 0.868;and for Coprococcus,7.589 lg CFU/g,with a

关 键 词：抽动障碍 儿童 肠道菌群 影响因素 受试者工作曲线 

分 类 号：R749.94[医药卫生—神经病学与精神病学]