粪菌移植治疗儿童难治性功能性便秘4例

Clinical effects of fecal microbiota transplantation in treatment of 4 cases of refractory functional constipation in children

目的观察粪菌移植对儿童难治性功能性便秘的临床疗效并探讨其机制。方法对4例临床确诊为难治性功能性便秘患儿给予粪菌移植治疗,观察和记录患儿临床症状改善情况并收集供体和粪菌移植治疗前后患儿粪便标本,利用Illumina MiSeq测序平台进行16S rRNA测序,并对测序结果进行生物信息学分析。结果4例患儿接受粪菌移植治疗后排便状况明显改善,大便次数增加、粪便硬度变软、腹部胀痛明显缓解。粪菌移植后,患儿肠道菌群多样性下降,患儿与供体的肠道菌群差异先增大后逐渐缩小。菌群分析显示患儿肠道有害菌受到抑制、有益菌增加。结论粪菌移植可有效改善儿童难治性功能性便秘的临床症状,具有疗程短、治疗方便、无明显不良反应等优点。

Objective To explore the clinical effects and mechanisms of fecal microbiota transplantation(FMT)for refractory pediatric functional constipation.Methods Four children with refractory functional constipation were treated with FMT.The clinical symptoms were observed;the stool samples of donors and recipients before and after FMT were collected for 16 SrRNA analysis with the Illumina MiSeq sequencing platform and bioinformatics software.Results The bowel movements of the 4 patients improved remarkably after FMT treatment;the frequency increased,the hardness of the stool lowered,and the abdominal distention and pain relieved.After FMT,the intestinal flora diversity of patients declined.Flora analysis showed that the differences in intestinal flora between donors and recipients increased first,then decreased gradually,with the inhibition of harmful bacteria and the expansion of beneficial ones.Conclusion FMT can improve the clinical symptoms of refractory functional constipation effectively in children,which is a safe,convenient,short-course and promising new method.