伴非自杀性自伤行为青少年双相障碍抑郁发作患者肠道菌群微生态特征

Microecological characteristics of intestinal flora in adolescents with depressive episode of bipolar disorder accompanied by non-suicidal self-injury

目的探讨伴有非自杀性自伤(non-suicidal self-injury,NSSI)行为的青少年双相障碍抑郁发作患者肠道菌群微生态特征。方法纳入伴有NSSI青少年双相障碍抑郁发作期患者(伴有NSSI组)30例,不伴有NSSI青少年双相障碍抑郁发作期患者(不伴有NSSI组)29例,以及健康对照者31名。收集受试者一般临床资料,并采集粪便标本,应用16S rRNA技术检测肠道菌群组成和丰度。结果三组间菌群Alpha多样性指标差异均有统计学意义(P<0.05),伴有NSSI组与不伴有NSSI组的菌群Chao1指数(241.11±591.11、246.04±54.41 vs.201.55±69.54)、Ace指数(25.12±3.67、21.42±5.13 vs.19.02±54.73)、Shannon指数(5.02±0.83、4.71±0.62 vs.3.72±0.91)、Simpson指数(0.95±0.17、0.93±0.04 vs.0.82±0.18)高于对照组(P<0.05),并且伴有NSSI组的Ace指数高于不伴有NSSI组(P<0.05)。较之对照组,伴有NSSI组与不伴有NSSI组厚壁菌门、变形菌门及梭杆菌属相对丰度上调,而放线菌门、拟杆菌门及肠球菌属相对丰度下调,差异有统计学意义(P<0.05)。伴有NSSI组厚壁菌门的相对丰度与17项汉密尔顿抑郁量表总分(r=0.41,P=0.02)及渥太华自伤量表中近1年的自伤频率(r=0.37,P=0.03)呈正相关。结论伴有NSSI青少年双相障碍抑郁发作患者肠道菌群多样性增加,肠道菌群构成及相对丰度在门水平及属水平上发生改变。

Objective To explore the microecological characteristics of intestinal flora in adolescents with depressive episode of bipolar disorder accompanied by non-suicidal self-injury(NSSI).Methods Thirty adolescents with depressive episode of bipolar disorder accompanied by NSSI(with NSSI group),29 adolescents with depressive episode of bipolar disorder without NSSI(without NSSI group)and 31 healthy controls were included in the study.The general clinical data of the subjects and stool samples were collected.16S rRNA technology was used to detect the composition and abundance of intestinal flora.Results There were significant differences among the three groups in the index of microbial alpha diversity.Chao1 index(241.11±591.11,246.04±54.41 vs.201.55±69.54),Ace index(25.12±3.67,21.42±5.13 vs.19.02±54.73),Shannon index(5.02±0.83,4.71±0.62 vs.3.72±0.91),Simpson index(0.95±0.17,0.93±0.04 vs.0.82±0.18)in the group with NSSI and the group without NSSI were higher than those in the control group(P<0.05).Ace index in the group with NSSI was higher than that in the group without NSSI(P<0.05).Compared with the control group,the relative abundance of Firmicutes,Proteus and Fusobacterium was increased in the group with NSSI and the group without NSSI,while the relative abundance of Actinomycetes,Bacteroides and Enterococcus was decreased.The relative abundance of Firmicutes in the group with NSSI was positively correlated with the total score of 17-item Hamilton Depression Scale(HAMD-17)(r=0.41,P=0.02)and the frequency of self-injury in the Ottawa Self Injury Scale(r=0.37,P=0.03)in recent one year.Conclusion In adolescents with bipolar depressive episode associated with NSSI,intestinal flora diversity increases,intestinal flora composition and relative abundance change at the phylum and genus levels.