【摘要】 目的:探讨过敏性紫癜(HSP)不同临床表型患儿与健康儿童肠道菌群结构和多样性差异。方法:收集30例HSP患儿的粪便标本,其中单纯紫癜型、消化道出血型、肾损伤型患儿各10例,以10例健康儿童粪便作为对照,提取粪便DNA,对16S rRNA基因的V4区进行高通量测序,并进行生物信息学分析。结果:与健康儿童相比,HSP肾损伤型患儿普雷沃氏菌种(科到种水平)、芽殖菌种(属到种水平)、脱硫弧菌属(目到属水平)、Barnesiellaceae科丰度明显提高,而乳酸杆菌目、双歧杆菌属丰度明显降低;消化道出血型患儿中变形菌门、δ变形菌纲、脱硫弧菌科(目到科水平)、Oscillospira属、Parabacteroides属丰度明显增高,而双歧杆菌科(目到科水平)、链球菌科(目到科水平)丰度明显降低;单纯紫癜型患儿中梭形杆菌属(门到属水平)、双歧杆菌属(门到属水平)丰度明显降低(P<0.05);与HSP单纯紫癜型患儿相比,HSP肾损伤型患儿中普雷沃氏菌科、Barnesiellaceae科丰度提高,消化道出血型患儿中梭形杆菌属(门到属水平)丰度明显提高;与HSP消化道出血型患儿相比,HSP肾损伤型患儿中芽殖菌种(属到种水平)丰度明显提高,而变形菌门丰度明显降低(P<0.05);HSP患儿芽殖菌属丰度与血清IL-6、IgA、IgG水平呈正相关,普雷沃氏菌属丰度与血清IL-8水平呈正相关,而双歧杆菌属丰度与血清IL-10呈负相关(P<0.05)。结论:HSP不同临床表型患儿存在肠道菌群紊乱,且HSP患儿肠道菌群变化可反映其脏器损伤程度,HSP患儿肠道菌群紊乱与全身免疫反应相关。更多还原

【Abstract】 Objective:To investigate differences in intestinal flora structure and diversity among children with different clinical phenotypes of Henoch-Sch■nlein Purpura and healthy children.Methods:Stool samples were collected from 30 children with HSP,including 10 children with HSP of simple purpura type,10 children with gastrointestinal hemorrhage type and 10 children with renal injury type.Stool samples were collected from 10 healthy children as control group.Fecal DNA were extracted,and V4 region of 16 S rRNA gene was sequenced by high-throughput sequencing and submitted for bioinformatics analysis.Results:Compared with healthy children,abundances of Prevotella(family to species level),Gemmiger(genus to species level),Fusobacterium(order to genus level),Barnesiellaceae in children with HSP of renal injury type were increased significantly,while abundances of Lactobacillales and Bifidobacterium decreased significantly.Abundances of Proteobacteria,Deltaproteobacteria,Desulfovibrioaceae(order to family level),Oscillospira and Parabacteroides in children with HSP of gastrointestinal bleeding type were increased significantly,while abundances of Bifidobacteria(order to family level),Streptococcus(phylum to family level) were decreased significantly(P<0.05).Abundances of Fusobacterium(phylum to genus level),Bifidobacterium(phylum to genus level) in pure purpura type were decreased significantly(P<0.05).Compared with children with HSP of pure purpura type,abundances of Prevotellaceae and Barnesiellaceae in children with HSP of renal injury type were increased significantly,abundances of Fusobacterium(phylum to genus level) in children with HSP of gastrointestinal bleeding type were increased significantly.Compared with children with HSP of gastrointestinal bleeding type,abundance of Gemmiger(genus to species level) in children with HSP of renal injury type was increased significantly,while abundance of Proteobacteria was decreased significantly(P<0.05).Serum IL-6,IgA,IgG level of children with HSP were positively correlated with Gemmiger abundance,and serum IL-8 level of children with HSP was positively correlated with Prevotella abundance,while IL-10 level was negatively correlated with Bifidobacterium abundance(P<0.05).Conclusion:Children with different clinical phenotypes had intestinal flora disorders,and changes of intestinal flora in children with HSP could reflect degree of organ damage.Disorders of intestinal flora in children with HSP were related to systemic immune response.更多还原