学龄前阻塞性睡眠呼吸暂停低通气综合征儿童肠道菌群特征分析

Analysis of Intestinal Flora Characteristics in Preschool Children with Obstructive Sleep Apnea Hypopnea Syndrome

目的:探讨学龄前阻塞性睡眠呼吸暂停低通气综合征(OSAHS)儿童与正常儿童肠道菌群的差异。方法:选取2023年7月至2023年11月期间新疆医科大学第一附属医院儿科门诊收治的学龄前OSAHS儿童30例作为OSAHS组,选取同期于新疆医科大学第一附属医院健康管理中心体检健康的儿童30例作为对照组。利用16SrDNA扩增子测序技术对肠道菌群进行分析。采用Spearman法分析睡眠质量与肠道菌群门、属水平丰度的相关性。结果:OSAHS组和对照组共发现2588个扩增子序列变异(ASVs),OSAHS组检出特有ASVs 1034个,对照组检出特有ASVs 1554个。OSAHS组Chao1指数和Observed otus指数显著低于对照组(P<0.05),两组间Shannnon指数、Simpson指数、Goods coverage指数、Peilou-e指数均差异无统计学意义(P>0.05)。OSAHS组与对照组间肠道菌群群落结构存在显著差异(P<0.05)。在门水平上,OSAHS组拟杆菌门的相对丰度低于对照组,厚壁菌门的相对丰度、厚壁菌门/拟杆菌门的比例高于对照组(P<0.05)。在属水平上,OSAHS组与对照组组优势菌群相对分度比较差异无统计学意义(P>0.05)。在门水平上,睡眠质量与拟杆菌门呈正相关(P<0.05)。在属水平上,睡眠质量与双歧杆菌属、乳杆菌属呈负相关,与拟杆菌属呈正相关(P<0.05)。阻塞性呼吸暂停低通气指数(OAHI)与肠杆菌属呈负相关(P<0.05)。最低血氧饱和度(LSaO_(2))与肠杆菌属呈正相关(P<0.05)。平均血氧饱和度(MSaO_(2))与X.Eubacterium._eligens_group呈正相关(P<0.05)。结论:与正常儿童的肠道菌群的种类和相对丰度相比,学龄前OSAHS儿童的厚壁菌门/拟杆菌门比例升高,可能存在肠道菌群失调。睡眠质量在门、属水平上与拟杆菌门、双歧杆菌属、乳杆菌属明显相关。

Objective:To investigate the difference of intestinal flora between preschool children with obstructive sleep apnea hypopnea syndrome(OSAHS)and normal children.Methods:30 preschool children with OSAHS admitted to the pediatric outpatient department of the First Affiliated Hospital of Xinjiang Medical University from July 2023 to November 2023 were selected as OSAHS group,and 30 healthy children who underwent physical examination in the health management center of our hospital during the same period were selected as control group.The intestinal flora was analyzed by 16 SrDNA amplicon sequencing technology.The correlation between sleep quality and the abundance of intestinal flora at phylum and genus levels were analyzed by Spearman method.Results:2588 amplicon sequence variations(ASVs)were found in OSAHS group and control group,1034 unique ASVs were detected in OSAHS group and 1554 unique ASVs were detected in control group.Chao1 index and Observed otus index in OSAHS group were significantly lower than those in control group(P<0.05),there was no significant difference in shannnon index,Simpson index,Goods coverage index and peilou-e index between two groups(P>0.05).There was a significant difference in the structure of intestinal flora between OSAHS group and control group(P<0.05).At the phylum level,the relative abundance of Bacteroidetes in OSAHS group was lower than that in control group,and the relative abundance of Firmicutes and the ratio of Firmicutes/Bacteroidetes were higher than those in control group(P<0.05).At the genus level,there was no significant difference in the relative index of dominant bacteria between OSAHS group and control group(P>0.05).At the phylum level,sleep quality was positively correlated with Bacteroidetes(P<0.05).At the genus level,sleep quality was negatively correlated with Bifidobacterium and Lactobacillus,and positively correlated with Bacteroides(P<0.05).Obstructive apnea hypopnea index(OAHI)was negatively correlated with Enterobacter(P<0.05).The lowest oxygen saturation(LSaO_(2))was positively corre lated with Enterobacter(P<0.05).Mean oxygen saturation(MSaO_(2))was positively correlated with X.Eubacterium._eli-gens_group(P<0.05).Conclusion:There are differences in the types and relative abundance of intestinal flora between preschool OSAHS children and normal children,the proportion of Firmicutes/Bacteroidetes is increase,and there may be intestinal flora imbalance.Sleep quality is significantly correlate with Bacteroidetes,Bifidobacterium,and Lactobacillus at the phylum and genus levels.