上海市杨浦地区3~5岁儿童口腔微生物菌群结构与患龋程度的相关性研究

doi:10.13701/j.cnki.kqyxyj.2025.06.009

摘要/Abstract

摘要： 目的: 对上海杨浦地区3~5岁不同患龋儿童唾液进行高通量测序,分析低龄儿童龋病(early childhood caries,ECC)口腔微生物菌群结构及唾液生化指标,探究龋病状况与菌群的相关性。方法: 依据儿童口腔检查结果分为ECC组、重度低龄儿童龋病(severe early childhood caries,SECC)和对照组。采集儿童唾液样本检测唾液生化指标并进行高通量测序分析菌群结构。线性回归分析唾液生化指标与乳牙龋失补指数(decayed-missing-filled teeth index,DMFT)关系,置换多元方差分析细菌种丰度与DMFT相关性,Logistic回归模型分析唾液细菌种丰度与唾液生化指标的相关性,Spearman相关性构建菌群物种间共存网络。结果: 患龋儿童唾液Mg²⁺、Ca²⁺、Cl^-、NH₄⁺、Br^-与DMFT呈线性正相关,NO₃^-、pH值与DMFT呈线性负相关(P＜0.05)。SECC组和ECC组产黑色素普雷沃菌、裂阿托波氏菌、极小阿托波氏菌、链球菌 AY020、变形链球菌丰度高于对照组,卟啉单胞菌 CW034、生痰二氧化碳嗜纤维菌、血链球菌丰度低于对照组(P＜0.05)。唾液变形链球菌丰度与DMFT指数正相关,卟啉单胞菌 CW034丰度与DMFT指数负相关(P＜0.05)。变形链球菌与K⁺、Mg²⁺、Cl^-、Br^-呈正相关,卟啉单胞菌 CW034与NO₃^-呈正相关(P＜0.05)。链球菌属与漫游球菌属、链球菌属与肠球菌属在共存网络中协同促进了ECC发生进展。结论: 不同龋病程度儿童唾液生化指标与微生物菌群结构存在差异,变形链球菌和卟啉单胞菌 CW034可能是儿童早期患龋及重度龋病进展的临床指示菌种。

关键词: 低龄儿童龋病, 重度低龄儿童龋病, 唾液, 微生物菌群

Abstract: Objective: To analyze the structure of oral microflora and salivary biochemical indexes of early childhood caries (ECC), and to investigate the correlation between the caries status and the bacterial flora, through high-throughput sequencing on the saliva of different caries-affected children aged 3-5 years in Yangpu District, Shanghai. Methods: The children were divided into ECC group, severe early childhood caries (SECC), and control group based on their oral examination results. Saliva samples were collected to test the salivary biochemical indexes and analyze the flora structure by high-throughput sequencing. Linear regression analysis was performed to analyze the relationship between salivary biochemical indicators and decayed-missing-filled teeth index (DMFT). Replacement multivariate analysis of variance was used to analyze the correlation between bacterial species abundance and DMFT. Logistic regression modeling was used to analyze the correlation between salivary bacterial species abundance and salivary biochemical indices. Spearman correlation was used to construct a coexistence network between bacterial species. Results: Salivary Mg²⁺, Ca²⁺, Cl^-, NH₄⁺, and Br^- of the caries-affected children showed a linear positive correlation with DMFT, and NO₃^- and pH showed a linear negative correlation with the DMFT index (P<0.05). The abundance of melanin-producing Prevotella, Atopobium fissiparum, Atopobium very small, Streptococcus AY020, and Streptococcus pyogenes was higher than that of the control group, and the abundance of Porphyromonas CW034, sputum-producing Carbon dioxide-fibrillophile, and Streptococcus haematococcus was lower than that of the control group in both the SECC and ECC groups (P<0.05). Salivary Streptococcus pyogenes abundance was positively correlated with DMFT index, and Porphyromonas CW034 abundance was negatively correlated with DMFT index (P<0.05). Streptococcus pyogenes was positively associated with K⁺, Mg²⁺, Cl^-, and Br^-, and Porphyromonas CW034 was positively associated with NO₃^- (P<0.05). Streptococcus spp. and Coccidioides difficile spp. and Streptococcus spp. and Enterococcus spp. synergistically contributed to the progression of ECC development in the coexistence network. Conclusion: Salivary biochemical parameters and microflora structure vary among children with different levels of caries, and Streptococcus pyogenes and Porphyromonas CW034 may be clinically indicative of early caries and progression to severe caries in children.

Key words: early childhood caries, severe early childhood caries, saliva, microflora

孙芳, 孟庆芳, 聂莉莉, 刘海霞. 上海市杨浦地区3~5岁儿童口腔微生物菌群结构与患龋程度的相关性研究[J]. 口腔医学研究, 2025, 41(6): 503-510.

SUN Fang, MENG Qingfang, NIE Lili, LIU Haixia. Structure of Oral Microflora and Its Correlation with Caries in Children Aged 3-5 Years Old in Yangpu of Shanghai[J]. Journal of Oral Science Research, 2025, 41(6): 503-510.

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