摘要
目的孤独症(autism spectrum disorders,ASD)发病机制不明,患病率逐渐增多,缺乏客观诊断指标,常规治疗主要依靠教育和行为训练,但效果十分有限。本研究通过胃肠镜粪微生态制品移植(fecal microbiota transplantation,FMT)治疗儿童孤独症1例,探索其疗效和可行性。方法参照本课题组报道的方法,收集通过严格筛选的供体粪便,体外制备粪微生态制品。孤独症患儿,男性,8岁,确诊孤独症5年余,合并功能性消化不良症状。静脉麻醉下,分别经胃镜、肠镜行粪微生态制品大肠和小肠注入。以临床评价、患儿的生活行为观察(来自患儿主要照顾者),孤独症行为评定检查表(autism behaviorchecklist,ABC),儿童期孤独症评定量表(childhood autism rating scale,CARS)进行治疗前后评估和对比。结果治疗前患儿ABC量表评分为112分,CARS量表积分为38分;治疗后8周,ABC量表评分降低至76分,CARS量表积分降低至32分,积分改善非常显著。语言、沟通、感觉、运动、自我照顾的各项能力整体提高,同时患儿在睡眠障碍、胃肠道症状、情绪方面有明显改善,尤其是胃肠道症状(呃逆)显著缓解。结论粪微生态制品移植对该例孤独症患儿的治疗,疗效明显,未见明显副反应,提示粪微生态制品移植对孤独症患儿可能是一种潜在的新疗法,但其长期疗效、不良反应有待多样本的深入研究。
Objective To explore the feasibility and efficacy of fecal microbiota transplantation（FMT） via gastroscopy/colonscopy into small intestine/colon for the treatment of autism spectrum disorder（ASD）.Methods With reference to the protocol published by our team,fecal microbiota suspension collected from a rigorously screened healthy donor was prepared in vitro.An 8-year-old boy with a history of more than five years autism and concomitant functional dyspepsia-like symptoms was admitted into our hospital and given FMT to small intestine and colon via endoscopy under anesthesia.The clinical evaluation,life behavior observation of the patient（from his primary caregiver）,and the scale evaluation（autism behavior checklist,ABC;childhood autism rating scale,CARS） were the observed indicators before and after the FMT treatment.Results Before FMT treatment,the ABC and CARS were 112 and 38 respectively,which dropped to76 and 32 respectively eight weeks after treatment.The levels of the patient s language,communication,sensation,motion and self-care ability to self-care were generally improved.Meanwhile,his sleep disorders,stomach symptoms and emotional aspects were significantly ameliorated,especially the gastrointestinal symptoms（hiccups）.Conclusion The significant efficacy and high safety observed in this ASD case suggest that ASD is likely a disorder of gut dysbiosis and FMT may be a promising new biological therapy for autism children;however,the long-term efficacy and adverse reactions of FMT need be studied further and verified with more cases.
出处
《中国微生态学杂志》
CAS
CSCD
2017年第3期309-312,共4页
Chinese Journal of Microecology
基金
国家高技术研究与开发项目(863)(2015AA020701):肠道微生态关键技术研究
关键词
粪微生态制品移植
治疗
孤独症
Fecal microbiota transplantation
Treatment
Autism spectrum disorders
