【摘要】 目的 比较不同海拔地区功能性便秘(FC)患者临床特点和肠道菌群差异。方法 于2023年11月～2024年11月连续招募居住于北京地区(平均海拔20～60 m)的FC患者(平原组，n=78)和同期居住于青海省西宁市(平均海拔2 261 m)的FC患者(高原组，n=30)。所有患者均完成饮食、便秘症状严重程度评分(KESS)、便秘患者生活质量评分(PAC-QOL)、焦虑自评量表(SAS)和抑郁自评量表(SDS)等问卷。采集5 g新鲜粪便行16S rDNA测序。比较两组患者的临床特征和肠道菌群差异。结果 平原组患者每日定时定量进餐、坚持进食新鲜水果和坚持进食新鲜蔬菜的比例以及KESS评分均高于高原组患者，PAC-QOL和SDS评分均低于高原组患者，差异均有统计学意义(P<0.05)。平原组菌群多样性高于高原组，两组的β多样性亦存在差异(P<0.05)。两组共享多数优势菌属，但构成比不同。高原组Streptococcus、Actinomyces、Schaalia、Rothia和Fructilactobacillus显著增多。微生物网络分析结果显示，高原组菌群网络更加紧密，节点数和连接度增加，群落稳定性更高。结论 高海拔与低海拔地区FC患者的临床特征和肠道菌群存在显著差异。高海拔地区FC的治疗应结合患者环境特点和生活习惯制定个体化慢病精准干预策略，在基础治疗的同时优化饮食结构并调节肠道微生态。更多还原

【Abstract】 Objective Comparison of clinical characteristics and gut microbiota in functional constipation(FC)patients across different altitudes. Methods 78 FC patients living in Beijing(Plain group)from October 2023 to December 2024 and 30 FC patients living in Qinghai Province(Plateau group)during the same period were included consecutively. After enrollment, all patients filled out questionnaires, including demographic data, diet status and constipation symptom severity score(KESS),constipation quality of life score(PAC-QOL),Zung Self-Rating Anxiety/Depression Scale(SAS/SDS)and other clinical data. At the same time, 5g of fresh feces were taken for high-throughput 16SrDNA sequencing. To analyze and compare the clinical characteristics and gut microbiota differences between the two patient groups. Results Compared with the Plain group, patients in the Plateau group had significantly lower daily intake of fresh fruits and vegetables. Although the KESS score was low, the PAC-QOL and SDS scores were significantly higher. The richness and diversity of flora in Plain group were higher than those in Plateau group. There are also differences in beta diversity between the two groups of bacterial groups. Although the two groups share most dominant bacterial genera, there are significant differences in their relative abundance and composition ratios. Analysis of differential bacterial genera also found that Streptococcus,Actinomyces,Schaalia,Rothia and Fructilactobacilli increased significantly in the Plateau group. There are also significant differences in the topological structure of the microbial network between the two groups. The Plateau group has a closer bacterial network structure, which is reflected in the increase in the number and connectivity of nodes, and the overall community stability is relatively higher. Conclusion There are differences in clinical characteristics and intestinal flora disorders in FC patients at different altitudes. The treatment of FC in high-altitude areas should be combined with the characteristics of the patients’ living geographical environment and living habits, and individualized and precise intervention strategies should be formulated to optimize the diet structure and adjust the intestinal microecology while basic treatment.更多还原