自闭症患儿肠道症状及菌群与行为的相关性

Correlation Between Intestinal Symptoms and Microflora and Behavior in Children with Autism

目的探究自闭症患儿肠道症状及菌群与行为的关系。方法选取2016年9月到2018年3月昌吉市特教机构训练的204例自闭症(ASD)患儿作为ASD组,另选52例普通幼儿园和小学正常儿童作为对照组,收集纳入对象粪便样本,采用菌属16srRNA V3序列引物分析两组肠道菌群分布情况,采用孤独症行为量表(ABC)和儿童孤独症评估量表(CARS)评价患儿行为情况,并分析ASD患儿肠道症状、菌群与行为的相关性。结果ASD组便秘、腹胀、肠道症状总分高于对照组,差异具有统计学意义(P<0.05);ASD组ABC、CARS评分均高于对照组,差异具有统计学意义(P<0.05);ASD组双歧杆菌、链球菌数量多于对照组,拟杆菌数目低于对照组,差异具有统计学意义(P<0.05);Spearman相关性分析显示,ASD患儿便秘、肠道症状总分、链球菌与ABC评分、CARS评分呈正相关(r=0.743,0.681;0.804,0.836;0.917,0.924,P<0.05),拟杆菌与ABC、CARS评分呈负相关(r=0.847、0.907,P<0.05)。结论ASD患儿的肠道症状和肠道菌群与其行为问题存在一定相关性,临床工作中可通过调整患儿菌群结构、改善肠道功能紊乱,从而达到对ASD的治疗效果。

Objective To investigate the relationship between intestinal symptoms and microflora and behavior in children with autism.Methods From September 2016 to March 2018,204 children with Autism spectrum disorders(ASD)who were admitted to special education institutions in our city were enrolled as ASD group.Other 52 normal children from kindergartens and primary school were selected as the control group.The 16 sr RNA V3 sequence primers were used to analyze the distribution of intestinal flora in the two groups.The behavioral status of the children was evaluated by the Autism Behavior Scale(ABC)and the Childhood Autism Rating Scale(CARS).The correlation between intestinal symptoms,flora and behavior in children with ASD was analyzed.Results The total scores of constipation,abdominal distension and intestinal symptoms in the ASD group were higher than those in the control group(P<0.05).The ABC and CARS scores in the ASD group were higher than those in the control group(P<0.05).The number of Bifidobacteria and Streptococcus in the ASD group was higher than that in the control group,while the number of Bacteroides was lower than that in the control group(P<0.05).The Spearman correlation analysis showed that the total score of constipation,intestinal symptoms and Streptococcus in children with ASD was positively correlated with ABC score and CARS score(r=0.743,0.681;0.804,0.836;0.917,0.924,P<0.05),and the Bacteroides was negatively correlated with ABC and CARS scores(r=0.847、0.907,P<0.05).Conclusions There is a certain correlation between intestinal symptoms and intestinal flora and its behaviors in children with ASD.In clinical work,the therapeutic effect of ASD can be achieved by adjusting the structure of the children’s flora and improving intestinal dysfunction.