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背景:有报道指出,孤独症谱系障碍(ASD)患儿的胃肠道(GI)症状发生率较高。然而,有关ASD患儿胃肠道微生物的研究结果不尽一致。目的 :系统复习相关研究结果,分析ASD患儿各种胃肠道微生物的分布特征。方法 :检索PubMed、Embase、PsycINFO、ISI web of knowledge、Ovid/Medline、Cochrane Library、中国知识资源总库、中国科技期刊数据库、万方数据检索系统,以及中国生物医学文摘数据库,收集有关ASD患者胃肠道微生物的文献,按照预先制定的纳入及排除标准筛选相关研究。采用Review manger 5.2.6软件进行统计分析。结果 :最终共纳入15项小样本横断面研究,其中1项来自于中国。在15项研究中,11项研究(合并样本为562例)报道ASD患儿组与对照组的胃肠道细菌患病率有显著性差异,尤其是厚壁菌,类杆菌和变形菌。但是,由于方法学上较大的异质性以及不同研究结果之间的相互矛盾,我们无法汇集结果进行meta分析。结论 :目前对ASD患儿胃肠道微生物的研究数量和质量都非常有限。然而,的确有一个“信号”表明ASD患儿的胃肠道微生物和没有ASD的儿童是有显著差异的,因此,继续开展此方面的研究是非常有价值的。为了提高研究的效度,减少研究结果的异质性,将来的研究需要增大样本,标准化方法以及评估相关混杂因素,例如胃肠道症状的严重程度,以及药物,特殊饮食和添加剂的使用情况。
Background: It has been reported that children with autism spectrum disorder (ASD) have a higher incidence of gastrointestinal (GI) symptoms. However, there are conflicting findings on gastrointestinal micro-organisms in children with ASD. OBJECTIVE: To systematically review the relevant research results and analyze the distribution characteristics of various gastrointestinal micro-organisms in children with ASD. Methods: PubMed, Embase, PsycINFO, ISI web of knowledge, Ovid / Medline, Cochrane Library, China Knowledge Base, China Science and Technology Periodical Database, Wanfang Data Retrieval System and China Biomedical Abstracts Database were searched. Gut microbiota literature, in accordance with the pre-established inclusion and exclusion criteria screening related research. Review manger 5.2.6 software for statistical analysis. Results: A total of 15 small sample cross-sectional studies were included, of which 1 came from China. In 15 studies, 11 studies (562 pooled) reported significant differences in the prevalence of gastrointestinal bacteria among children with ASD and controls, in particular, Firmicutes, Bacteroides and Proteobacteria. However, due to greater methodological heterogeneity and the conflicting results of different studies, we were unable to compile a meta-analysis of the results. Conclusion: At present, the quantity and quality of gastrointestinal microbes in children with ASD are very limited. However, there is indeed a “signal” that shows significant differences between children with ASD and those without ASD, so continuing research in this area is very valuable. In order to increase the validity of studies and reduce the heterogeneity of research results, future studies will need to increase samples, standardize methods and evaluate relevant confounding factors such as the severity of gastrointestinal symptoms and the use of medications, special diets and supplements .