实用临床医药杂志2026，Vol.30Issue(3)：49-53,62,6.DOI:10.7619/jcmp.20256267
肠道菌群特征性改变预测儿童幽门螺杆菌治疗结果及耐药性
Characteristic changes in gut microbiota in predicting treatment outcomes and drug resistance in children with Helicobacter pylori infection
摘要
Abstract
Objective To investigate the characteristic changes in gut microbiota before treat-ment in children with Helicobacter pylori(H.pylori)infection,and to analyze the predictive value of differential gut microbiota for treatment outcomes and drug resistance.Methods A total of 168 chil-dren with H.pylori infection were enrolled and treated with standard quadruple therapy for 14 days.Based on eradication efficacy,they were divided into eradication success group(118 cases)and e-radication failure group(50 cases);based on drug susceptibility results,they were divided into sen-sitive group(112 cases)and resistant group(56 cases).Fecal samples were collected from the chil-dren before treatment,and gut microbiota diversity and composition were analyzed using 16S rRNA high-throughput sequencing.LEfSe was employed to screen for differential bacterial genera.The re-ceiver operating characteristic(ROC)curve was used to evaluate the performance of differential gut microbiota in predicting treatment outcomes and drug resistance in children with H.pylori infection.Results The Shannon index and Simpson index of gut microbiota before treatment in the eradication failure group were lower than those in the eradication success group,with statistically significant differences(P＜0.001).The Shannon index of gut microbiota before treatment in the resistant group was lower than that in the sensitive group,with statistically significant difference(P＜0.001).Significant differences in gut microbiota structure were observed between the eradication success and eradication failure groups,as well as between the sensitive and resistant groups(P＜0.01).The abundances of Bifidobacterium and Lactobacillus in the eradication success group were higher than those in the erad-ication failure group,while the abundances of Bifidobacterium and Akkermansia in the sensitive group were higher than those in the resistant group(LD A＞3.0,P＜0.05).The abundance of op-portunistic pathogenic bacteria such as Enterococcus in the eradication failure group and the drug-re-sistant group increased(LDA＞3.0,P＜0.05).The area under the curve(AUC)for predicting e-radication success using Bifidobacterium combined with Lactobacillus was 0.885(95％CI,0.832 to 0.938);the AUC forpredicting H.pylori sensitivity using Bifidobacterium combined with Akkerman-sia was 0.912(95％CI,0.865 to0.959).The net benefit of the combined models was superior to that of single bacterial genus prediction.Conclusion Characteristic changes exist in the gut micro-biota of children with H.pylori infection before treatment,among which Bifidobacterium,Lactobacillus and Akkermansia demonstrate good predictive value for treatment outcomes and drug resistance.关键词
儿童/幽门螺杆菌/肠道菌群/根除/药物耐药性/预测效能/双歧杆菌属/高通量测序Key words
children/Helicobacter pylori/gut microbiota/eradication/drug resistance/predic-tive performance/Bifidobacterium/high throughput sequencing分类
医药卫生引用本文复制引用
刘俊莹,赵欣,郑博娟,王晓娟..肠道菌群特征性改变预测儿童幽门螺杆菌治疗结果及耐药性[J].实用临床医药杂志,2026,30(3):49-53,62,6.基金项目
国家自然科学基金项目(821501961) （821501961）
河北省卫生健康委医学科学研究计划课题(20190831) （20190831）
