儿童功能性便秘肠道传输功能与肠道微生态的关系

Relationship between the gut microbiota and colonic transit function in chronic functional constipation children

目的采用不透光X线标志物测定结肠传输指数(TI)对功能性排便障碍进行分型,探讨各型功能性便秘患儿之间及其与健康儿童之间肠道菌群差异。方法选取功能性便秘儿童40例,进行结肠传输试验并进行分型,其中33例出口梗阻型(出口梗阻组),7例慢传输型(慢传输组)。留取便秘儿童新鲜粪便样本,同时收集20例正常儿童(对照组)粪便标本,存放于-80℃冰箱。采用16S rRNA测序技术鉴定菌群。结果菌群多样性分析:出口梗阻组、慢传输组与对照组粪便标本在丰富度上差异存在统计学意义(P<0.01),出口梗阻组、慢传输组的肠道菌群丰度明显增高,3组在多样性上差异无统计学意义。门水平分析:出口梗阻型与慢传输型相比、出口梗阻型儿童与健康儿童相比,差异均无统计学意义;拟杆菌门丰度慢传输型儿童较健康儿童高,差异存在统计学意义(P<0.05)。属水平分析:出口梗阻型与慢传输型相比,Subdoligranulum、Ruminococcus_2、Lachnospira、Collinsella数量在慢传输型儿童中均明显减少,差异存在统计学意义(均P<0.05);毛螺菌属、Lachnoclostridium、Anaerostipes、Dorea、志贺菌属丰度慢传输型儿童较健康儿童低(均P<0.05);Blautia、Anaerostipes、Lachnoclostridium丰度出口梗阻型儿童较健康儿童低(均P<0.05);Alistipes、Parasutterella、Ruminococcus_2、Ruminococcaceae_UCG 005、Ruminococcaceae_UCG 002丰度出口梗阻型儿童较健康儿童高(均P<0.05)。结论出口梗阻型与慢传输型相比,有部分菌种在慢传输型便秘儿童中明显减少,这需要进一步研究论证;便秘儿童肠道菌群与健康人群存在较大差异,改变肠道菌群可能成为治疗慢性功能性便秘的新策略。慢传输型便秘病例数较少,需增加样本量后进一步分析。

Objective To explore the differences in gut microbiota between child patients with different types of functional constipation(FC) and healthy controls(HCs). Methods Colon transit test was performed to determine the type of FC. A total of 40 children with FC, including 33 ones with outlet obstruction constipation(OOC) and 7 with slow transit constipation(STC), were enrolled. 16 S rRNA high throughout pyrosequencing on V3-V4 region was employed to examine the differences in gut microbiota profiles between the 40 FC patients and 20 healthy controls. The obtained data were analyzed using bioinformatics. Results The richness of gut microbiota in STC group and OOC group were higher than that in healthy controls(P<0.05), while no significant differences were observed in the flora diversity. There were significant differences in the structure of gut microbiota between CFC patients and HCs both at the phylum and genus levels(all P<0.05). At the phylum level, Bacteroidetes was richer in STC group than in HCs(P<0.05). At the genus level, Subdoligranulum, Ruminococcus_2, Lachnospira and Collinsella were less in STC group than in OOC group;Lachnospira, Lachnoclostridium, Anaerostipes, Dorea and Escherichia-Shigella were less in STC group than in HCs;Blautia, Anaerostipes and Lachnoclostridium were less in OOC group than in HCs, while Alistipes, Parasutterella, Ruminococcus_2, Ruminococcaceae_UCG-005 and Ruminococcaceae_UCG-002 were richer. Conclusion The relative abundances of some gut microbiota were found to have changed in OOC patients and STC patients. There are significant differences in the structure of gut microbiota between FC patients and HCs. Therefore, targeting the gut microbiota dysbiosis may be a promising therapeutic strategy for the treatment of FC. Since the size of STC is small, further analysis using larger sample size should be conducted.