儿童感染性腹泻肠道菌群α多样性与微量元素的动态关联性及临床预后价值
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福建省三明市妇幼保健儿科

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The dynamic correlation and clinical prognostic value of gut microbiota alpha diversity and trace elements in children with infectious diarrhea
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    摘要:

    目的:探讨儿童感染性腹泻肠道菌群α多样性与微量元素的动态关联性及临床预后价值。方法:选取2022年1月~2025年1月收治的100例感染性腹泻患儿展开前瞻性研究,抽取所有患儿粪便样本,应用十六烷基三甲基溴化铵(CTAB)法提取样本基因DNA,进行16Sr-DNA测序,分析Chao1指数、Simpson指数、Shannon指数及菌种数等指标,反映肠道菌群α多样性,依照四分位数,将肠道菌群α多样性分为高、低两组。比较高、低两组血液中微量元素含量。分析肠道菌群α多样性与治疗前后微量元素的相关性。随后依照临床预后情况将100例患儿分为两个亚组,即良好预后组(n=80)及不良预后组(n=20),比较两组Chao1指数、Simpson指数、Shannon指数及菌种数,采用Logistic回归法分析肠道菌群α多样性对感染性腹泻的预后预测价值。结果:高Chao1组钙、铁、锌、铜表达水平高于低Chao1组(P<0.05)。高Simpson组与低Simpson组钙、铁、锌、铜表达水平比较无差异(P>0.05)。高Shannon组钙、铁、锌、铜表达水平高于低Shannon组(P<0.05)。高菌种数组钙、铁、锌、铜表达水平高于低菌种数组(P<0.05);相关性分析显示,Chao1指数、Shannon指数和菌种数与四种微量元素均呈正相关(r=0.389~0.689,均P<0.05),而Simpson指数与各微量元素无相关性(P>0.05);良好预后组Chao1指数、Shannon指数、菌种数均高于不良预后组(P<0.05),良好预后组与不良预后组Simpson指数比较无差异(P>0.05);多因素Logistic回归分析显示,Chao1指数、Shannon指数及菌种数对感染性腹泻预后具有独立预测价值(P<0.05)。结论:儿童感染性腹泻患儿的肠道菌群α多样性与血液中钙、铁、锌、铜等微量元素水平存在密切关联,同时,肠道菌群α多样性中的Chao1指数、Shannon指数及菌种数可作为儿童感染性腹泻临床预后的独立预测指标。

    Abstract:

    Objective: To explore the dynamic correlation and clinical prognostic value between the diversity of gut microbiota alpha and trace elements in children with infectious diarrhea. Methods: A prospective study was conducted on 100 children with infectious diarrhea admitted from January 2022 to January 2025. Fecal samples were collected from all children, and gene DNA was extracted using the cetyltrimethylammonium bromide (CTAB) method. 16Sr DNA sequencing was performed to analyze Chao1 index, Simpson index, Shannon index, and bacterial count, reflecting the alpha diversity of the gut microbiota. According to quartiles, the alpha diversity of the gut microbiota was divided into high and low groups. Compare the levels of trace elements in the blood between the high and low groups. Analyze the correlation between gut microbiota alpha diversity and trace elements before and after treatment. Subsequently, 100 pediatric patients were divided into two subgroups based on clinical prognosis, namely the good prognosis group (n=80) and the poor prognosis group (n=20). The Chao1 index, Simpson index, Shannon index, and bacterial species were compared between the two groups, and logistic regression was used to analyze the prognostic value of gut microbiota alpha diversity for infectious diarrhea. Results: The expression levels of calcium, iron, zinc, and copper in the high Chao1 group were higher than those in the low Chao1 group (P<0.05). There was no significant difference in the expression levels of calcium, iron, zinc, and copper between the high Simpson group and the low Simpson group (P>0.05). The expression levels of calcium, iron, zinc, and copper in the high Shannon group were higher than those in the low Shannon group (P<0.05). The expression levels of calcium, iron, zinc, and copper in the high strain group were higher than those in the low strain group (P<0.05); Correlation analysis showed that Chao1 index, Shannon index, and bacterial species number were significantly positively correlated with the four trace elements (r=0.389~0.689, all P<0.05), while the Simpson index did not reach statistical significance with each trace element (P>0.05); The Chao1 index, Shannon index, and bacterial count in the good prognosis group were higher than those in the poor prognosis group (P<0.05), while there was no significant difference in Simpson index between the good prognosis group and the poor prognosis group (P>0.05); Multivariate logistic regression analysis showed that Chao1 index, Shannon index, and bacterial count have independent predictive value for the prognosis of infectious diarrhea (P<0.05). Conclusion: The alpha diversity of intestinal microbiota in children with infectious diarrhea is closely related to the levels of trace elements such as calcium, iron, zinc, and copper in the blood. At the same time, the Chao1 index, Shannon index, and bacterial count in the alpha diversity of intestinal microbiota can serve as independent predictive indicators for clinical prognosis of infectious diarrhea in children.

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吕秀华.儿童感染性腹泻肠道菌群α多样性与微量元素的动态关联性及临床预后价值[J].四川生理科学杂志,2025,47(12):

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  • 收稿日期:2025-07-31
  • 最后修改日期:2025-08-21
  • 录用日期:2025-09-02
  • 在线发布日期: 2026-01-04
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