慢性疲劳综合征不同年龄组人群肠道菌群特征分析

doi:10.12114/j.issn.1007-9572.2024.0288

摘要/Abstract

摘要： 背景慢性疲劳综合征（CFS）是一种病因不明的慢性衰弱性疾病，与肠道微生态失调和细菌代谢紊乱相关，CFS患者与健康人群肠道菌群组成和肠道通透性存在显著差异，但有关不同年龄CFS患者肠道菌群特征鲜见报道。目的探究不同年龄组CFS患者肠道菌群的特征，为不同年龄组CFS风险防控提供科学依据。方法选取2021年2—10月四川省中西医结合医院门诊CFS患者作为研究对象，分设3组：青年组（18~34岁）20例、中年组（35~55岁）20例和老年组（56~80岁）20例。收集病例基本信息，采集粪便标本，采用16S rRNA高通量测序方法检测肠道菌群，并对其进行生物信息学及统计分析。结果不同年龄段CFS患者的物种组成和相对丰度存在差异，老年组肠道菌群Pielou_e指数高于中年组（P<0.05）；中年组聚集菌群与另外两组存在差异（P<0.01）。青年组核心菌属为粪球菌属（Coprococcus）、巨单胞菌属（Megamonas）、戴阿利斯特杆菌属（Dialister）、不动杆菌属（Acinetobacter），老年组核心菌属为瘤胃球菌属（Ruminococcus）。青年组假单胞菌目（Pseudomonadales）、莫拉菌科（Moraxellaceae）、不动杆菌属（Acinetobacter）的相对丰度高于中年组和老年组（P<0.05）；中年组丹毒丝梭菌属（Erysipelatoclostridium）、Sellimonas属的相对丰度高于青年组和老年组（P<0.05）；老年组埃格特菌科（Eggerthellaceae）、嗜胆菌属（Bilophila）相对丰度高于青年组和中年组（P<0.05）。结论不同年龄组CFS患者肠道菌群多样性和组成存在差异，初步发现不动杆菌属和丹毒丝梭菌属可作为区别老年、中年及青年CFS患者肠道菌群的关键菌群。

关键词: 疲劳综合征，慢性, 年龄组, 肠道菌群, 不动杆菌属, 丹毒丝梭菌属, 16S rRNA

Abstract:

Background

Chronic fatigue syndrome (CFS) is a chronic debilitating disease of unknown etiology associated with intestinal microecological dysregulation and disturbances in bacterial metabolism, and there are significant differences in the composition of the intestinal flora and intestinal permeability between patients with CFS and healthy populations, but the characteristics of the intestinal flora suggestive of CFS populations of different ages have rarely been reported.

Objective

To explore the characteristics of intestinal flora of CFS patients in different age groups, and to provide scientific basis for risk prevention and control of CFS in different age stages.

Methods

CFS patients from outpatient clinics of Sichuan Integrative Medicine Hospital between February 2021 and October 2021 were selected as the study subjects, and divided into three groups: 20 cases in the young group (18-34 years old), 20 cases in the middle-aged group (35-55 years old), and 20 cases in the old-aged group (56-80 years old). Basic information of the cases was collected, stool specimens were collected, and 16S rRNA high-throughput sequencing was used to detect the intestinal flora, and bioinformatics and statistical analysis were performed.

Results

Differences in species composition and relative abundance were observed in CFS patients of different ages, with higher Pielou_e index of intestinal flora in the old-aged group, with statistically significant differences compared to the middle-aged group (P<0.05), and significant separation of the aggregated flora in the middle-aged group from the other two groups (P<0.01). Coprococcus, Megamonas, Dialister, and Acinetobacter were the core flora of the young group, and Ruminococcus was the core flora of the old group. The relative abundance of Pseudomonadales, Moraxellaceae, and Acinetobacter in the young group was higher than the middle-aged and old-aged groups (P<0.05). The relative abundance of Erysipelatoclostridium and Sellimonas in the middle-aged group was higher than the young and old-aged groups (P<0.05). The relative abundance of Eggerthellaceae and Bilophila in the old-aged group was higher than the young and the middle-aged group (P<0.05) .

Conclusion

There are differences in the diversity and composition of the intestinal flora of CFS patients in different age groups, and it was initially found that Acinetobacter and Erysipelatoclostridium can be used as the key flora to differentiate the intestinal flora of old-aged, middle-aged and young CFS patients.

Key words: Fatigue syndrome, chronic, Age groups, Intestinal flora, Acinetobacter, Erysipelatoclostridium, 16S rRNA

中图分类号:

R 746.9　R 378.2

徐乙莎,李春梅,王城城,等. 慢性疲劳综合征不同年龄组人群肠道菌群特征分析[J]. 中国全科医学, 2025, 28(23): 2900-2907. DOI: 10.12114/j.issn.1007-9572.2024.0288.
XU Yisha,LI Chunmei,WANG Chengcheng, et al. Characterization of Intestinal Flora in Different Age Groups with Chronic Fatigue Syndrome[J]. Chinese General Practice, 2025, 28(23): 2900-2907. DOI: 10.12114/j.issn.1007-9572.2024.0288.

图/表 7

表1 3组CFS患者一般资料比较

Table 1 Comparison of general data of CFS patients in 3 groups

组别	例数	性别（男/女）	年龄（岁）	总体疲劳（分）	躯体疲劳（分）	精神疲劳（分）	疲劳后果（分）	疲劳对睡眠/休息的反应[M（P₂₅，P₇₅），分]	疲劳的情境性（分）
青年组	20	7/13	21.8±0.3	53.60±4.47	52.65±4.71	56.80±5.01	52.15±4.78	63.00（25.00，84.75）	53.00±4.90
中年组	20	4/16	45.4±1.4^c	45.30±3.19	52.70±5.43	48.80±4.52	38.40±3.00^c	25.00（16.00，50.00）^c	49.25±3.86
老年组	20	5/15	66.4±1.1^cd	49.85±3.74	49.45±4.79	53.60±4.11	47.80±4.11	31.50（16.00，63.00）	50.75±3.47
检验统计量值		1.193^a	52.558^b	1.175	0.139	0.779	3.040	5.074^b	0.210
P值		0.551	<0.001	0.316	0.870	0.464	0.056	0.079	0.811

表2 CFS患者肠道菌群的α多样性分析[M（P25，P75）]

Table 2 Analysis of alpha diversity of intestinal flora in CFS patients

组别	例数	Pielou_e指数	Shannon指数	Observed_ASVs指数
青年组	20	0.72（0.69，0.75）	5.53（5.30，5.91）	211.50（192.00，248.00）
中年组	20	0.68（0.66，0.72）	5.40（5.08，5.61）	205.50（195.50，267.25）
老年组	20	0.73（0.70，0.77）^a	5.76（5.53，6.10）^a	239.00（201.75，254.75）
H值		6.912	5.590	1.562
P值		0.032	0.061	0.458

图1 不同年龄段CFS患者肠道菌群的β多样性分析注：a表示P<0.01。

Figure 1 Beta diversity analysis of intestinal flora in CFS patients of different age groups

图2 不同年龄段CFS患者肠道菌群的ASVs分布注：A为3组慢性疲劳综合征（CFS）患者共有或独有扩增子序列变异（ASVs），B为3组CFS患者肠道核心菌群。

Figure 2 Distribution of ASVs in the intestinal flora of CFS patients of different ages

图3 不同年龄段CFS患者门水平上肠道菌群物种组成图注：a表示P<0.05，b表示P<0.01；A表示3组CFS患者门水平上肠道菌群物种组成，Others表示除这10个门以外其他所有门相对丰度之和，B表示3组CFS患者肠道菌群相对丰度前10的门类，C表示3组CFS患者的厚壁菌门/拟杆菌门（Firmicutes/Bacteroidetes，F/B）比值。

Figure 3 Species composition of the intestinal flora at the portal level in CFS patients of different ages map

图4 不同年龄段CFS患者肠道菌群的LEfSe分析注：A表示3组差异菌群LDA图（P<0.1；lg[LDA]≥2.0）；B表示3组差异菌群气泡图，不同气泡颜色代表不同分组，气泡大小代表P值；C表示3组差异菌群进化图，从内部到外部呈圆形，表示从门到属（或种）的分类学等级。

Figure 4 LEfSe analysis of intestinal flora in CFS patients of different ages

图5 不同年龄段CFS患者肠道菌群的差异关键菌群

Figure 5 Differences key flora in intestinal flora in CFS patients of different ages

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