目的 观察不同控制水平哮喘患儿肠道菌群的差异。方法 选取2020年1月—2020年12月就诊的10~12岁哮喘儿童,依据哮喘控制水平分级标准分为控制组与未控制/部分控制组,同时将同期健康体检儿童作为对照组,留取新鲜粪便样本进行肠道菌群16S rRNA的检测。结果 共纳入哮喘患儿30例。控制组16例,男10例、女6例,年龄（12.19±1.11）岁;未控制/部分控制组14例,男8例、女6例,年龄（12.92±1.59）岁;对照组12例,男6例、女6例,年龄（13.17±1.03）岁。三组间性别、年龄差异均无统计学意义（P>0.05）。控制组治疗时间为（1.22±0.18）年,未控制/部分控制组为（1.24±0.15）年,差异无统计学意义（P>0.05）。三组间FEF₅₀绝对值差异有统计学意义（P<0.05）。三组之间Alpha多样性指数（4个指数）差异均无统计学意义（P>0.05）。未控制/部分控制组中韦荣球菌属（Veillonella）物种相对丰度为0.06（0.01~0.25）%,控制组为0.53（0.19~0.92）%,对照组为0.17（0.09~0.82）%,三组间差异有统计学意义（P<0.05）。两两比较发现,未控制/部分控制组中Veillonella丰度较控制组以及对照组明显降低,差异有统计学意义（P<0.05）。行ROC曲线分析可见,Veillonella丰度对哮喘控制水平预测的曲线下面积为0.82（95%CI：0.66~0.98）。结论 控制不佳的哮喘患儿肠道菌群中Veillonella丰度明显减少,对哮喘控制水平评估以及辅助治疗可能具有一定的指导意义。

Objectives To observe the difference of gut microbiota in children with asthma at different control levels. Methods Thirty children aged 10 to 12 with asthma were selected from January 2020 to December 2020 and divided into well-controlled group (16 patients) and non-control / partial control group (14 patients) according to the grading standard of asthma control level. Twelve healthy children were selected as the control group. Fresh fecal samples were collected from three group for the detection of 16S rRNA of gut microbiota. Results A total of 30 children with asthma were included. There were 16 cases in the well-controlled group, 10 males and 6 females, aged (12.19±1.11) years; 14 cases in the uncontrolled/partially controlled group, 8 males and 6 females, aged (12.92±1.59) years; and 12 cases in the control group, 6 males and 6 females, aged (13.17±1.03) years. The differences in gender and age among the three groups were not statistically significant (P>0.05). The duration of treatment was (1.22±0.18) years in the well-controlled group and (1.24±0.15) years in the uncontrolled/partially controlled group, with no statistically significant differences (P>0.05). The difference in the absolute value of FEF₅₀ among the three groups was statistically significant (P<0.05). The differences in Alpha diversity index (4 indices) among the three groups were not statistically significant (P>0.05). The relative abundance of Veillonella species in the uncontrolled/partially controlled group was 0.06 (0.01-0.25)%, 0.53 (0.19-0.92)% in the well-controlled group and 0.17 (0.09-0.82)% in the control group, with statistically significant differences among the three groups (P<0.05). A two-by-two comparison revealed that the abundance of Veillonella was significantly lower in the uncontrolled/partially controlled group compared to the well-controlled group as well as the control group, and the difference was statistically significant (P<0.05). ROC curve analysis showed that the area under the curve for the prediction of Veillonella abundance on the level of asthma control was 0.82 (95% CI: 0.66 to 0.98). Conclusions The abundance of Veillonella in the intestinal flora of poorly controlled asthmatic children was significantly reduced, which may be a guideline for the assessment of asthma control level as well as adjuvant therapy.