| 摘要: |
| 目的：探讨常见肠道菌群及其代谢产物在过敏性哮喘（AA）患儿病情进展中的作用。方法：选取2019年1月至2021年12月医院门急诊及住院收治的80例AA急性发作期患儿作为研究对象，参照《儿科学（第9版）》中AA急性发作期病情程度分级将患儿分为轻度组、中度组与重度组，比较不同病情程度AA急性发作期患儿的基线资料、常见肠道菌群及其代谢产物，重点分析常见肠道菌群及其代谢产物与AA急性发作期患儿病情程度的关系。结果：80例AA急性发作期患儿中轻度28例、中度34例、重度18例；轻度组患儿乳酸杆菌、双歧杆菌、乙酸、丁酸水平最高，其次为中度组，重度组最低，差异有统计学意义（P<0.05）；重度组患儿大肠埃希菌、脂多糖水平最高，其次为中度组，轻度组最低，差异有统计学意义（P<0.05）；经Kendall’s tau-b相关性检验显示，AA急性发作期患儿病情程度分级与乳酸杆菌、双歧杆菌、短链脂肪酸的乙酸与丁酸水平呈负相关（r<0，P<0.05），与大肠埃希菌、脂多糖水平呈正相关（r>0，P<0.05）；经有序回归分析显示，乳酸杆菌、双歧杆菌、乙酸、丁酸水平高是AA病情程度分级的保护因素（OR<1，P<0.05），大肠埃希菌、脂多糖水平高是其危险因素（OR>1，P<0.05）；绘制决策曲线结果显示，在高风险阈值0.0~1.0范围内乳酸杆菌、双歧杆菌、大肠埃希菌联合评估AA急性发作期患儿病情程度分级的净收益率均>0，乙酸、丁酸、脂多糖联合评估AA急性发作期患儿病情程度分级的净收益率均>0，有临床意义。结论：常见肠道菌群中乳酸杆菌、双歧杆菌、大肠埃希菌及其代谢产物乙酸、丁酸、脂多糖与AA急性发作期患儿病情程度有关，可能在AA的病情进展中发挥一定作用。 |
| 关键词: 过敏性哮喘 儿童 肠道菌群 代谢产物 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2022.12.009 |
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| 基金项目:2018 年江苏省妇幼健康科研项目,编号F201817。 |
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| Effects of Intestinal Flora and Its Metabolites in Children with Allergic Asthma |
| Teng Yan, Gu Ting, Ding Shouling, Zhang Baoqin |
| (The First People’s Hospital of Taicang, Jiangsu Suzhou 215400, China) |
| Abstract: |
| Objective: To explore the effects of common intestinal flora and its metabolites in the progression of allergic asthma (AA) in children. Methods: Eighty children with acute attack of AA admitted into outpatient, emergency and inpatient departments of the hospital from 2019 to 2021 were selected as the research subjects. All children were divided into the mild group, moderate group and severe group, according to the grading of acute attack of AA condition in Pediatrics (9th Edition). The baseline data, common intestinal flora and its metabolites of acute attack of AA in children with different disease degrees were compared. Correlation between common intestinal flora and its metabolites and the severity of children with acute attack of AA was emphatically analyzed. Results: Among 80 children with acute attack of AA, 28 cases were mild, 34 cases were moderate and 18 cases were severe. The levels of Lactobacillus, Bifidobacterium, acetic acid and butyric acid were the highest in the mild group, followed by the moderate group and the severe group, with statistically significant differences (P<0.05). The levels of Escherichia coli and lipopolysaccharide were the highest in the severe group, followed by the moderate group and the mild group, with statistically significant differences (P<0.05). Results of Kendall’s tau-b correlation test showed that the grade of acute attack of AA was negatively correlated with the levels of Lactobacillus, Bifidobacterium, acetic acid and butyric acid of short-chain fatty acids (r<0, P<0.05), and positively correlated with the levels of E. coli and lipopolysaccharide (r>0, P<0.05). Results of ordered regression analysis showed that the high levels of Lactobacillus, Bifidobacterium, acetic acid and butyric acid were the protective factors for the grading of AA (OR<1, P<0.05), and the high levels of Escherichia coli and lipopolysaccharide were the risk factors (OR>1, P<0.05). Results of decision curve showed that the net benefit rate of joint assessing the severity grading was more than 0 with Lactobacillus, Bifidobacterium and E. coli within the high-risk threshold range from 0.0 to 1.0, and was more than 0 with acetic acid, butyric acid and lipopolysaccharide, which had clinical significance. Conclusion: Lactobacillus, Bifidobacterium, E. coli and its metabolites acetic acid, butyric acid and lipopolysaccharide are correlated with the severity of acute attack of AA in children, and may play a role in the progression of AA. |
| Key words: allergic asthma children intestinal flora metabolites |
