心力衰竭患者肠道菌群失调与心脏血流动力学变化的相关性研究  

Correlation between dysbiosis of intestinal flora and cardiac hemodynamic changes in patients with heart failure

作　　者：雷鸣 胡祥勇 张百灵 LEI Ming;HU Xiangyong;ZHANG Bailing(Xiangri Autonomous Prefecture People's Hospital,Cardiorascular De partment 1,Xiangxi416000,Hunan,China)

机构地区：[1]湘西自治州人民医院心血管内一科,湖南湘西416000

出　　处：《中国病原生物学杂志》2024年第7期789-794,共6页Journal of Pathogen Biology

摘　　要：目的 评估心力衰竭患者肠道菌群的失调情况,并探索其与心脏血流动力学参数之间的相关性,为心力衰竭的病理机制研究和临床治疗提供新视角。方法 本研究为横断面观察性研究,于2023年4月至10月医院招募了30名心力衰竭患者和30名健康对照志愿者,两组在年龄、性别和BMI等基线特征上匹配。肠道菌群分析通过收集受试者粪便样本进行16S rRNA高通量测序。采用Spearman等级相关分析评估肠道菌群失调与心脏血流动力学参数,包括心输出量、左心室舒张末期容积之间的相关性。结果 心力衰竭组与健康对照组在肠道菌群结构上存在显著差异。心力衰竭患者乳杆菌属丰度显著降低(8.02%±3.43%vs. 10.48%±2.83%;P<0.05),产气荚膜梭菌属丰度也降低(8.05%±3.29%vs. 10.07%±3.06%;P<0.05),拟杆菌属丰度显著增加(10.32%±3.69%vs. 9.22%±2.53%;P<0.05)。心力衰竭患者的左心室舒张末期容积(EDV)与梭菌属的丰度呈正相关(P<0.05),而与拟杆菌属、乳杆菌属、产气荚膜梭菌属的丰度呈负相关。全身血管阻力(SVR)与拟杆菌属、乳杆菌属等多个属的丰度呈负相关(P<0.05)。结论 肠道菌群失调与心力衰竭患者的心脏血流动力学参数显著相关,提示肠道微生物组成的变化可能在心力衰竭的发病机制中发挥重要作用。这些结果强调了进一步研究肠道微生物群对心力衰竭影响的重要性,为未来治疗策略提供潜在的靶点。Objective To evaluate the imbalance of intestinal flora in patients with heart failure and explore its correlation with cardiac hemodynamic parameters,so as to provide a new perspective for the study of pathological mechanisms and clinical treatment of heart failure.Methods This study was a cross-sectional observational study,conducted at our Hospital from April to October 2023.A total of 30 heart failure patients and 30 healthy control volunteers were recruited,and the 2 groups were matched on baseline characteristics such as age,gender,and BMI.Intestinal flora analysis was performed by collecting fecal samples from subjects and performing 16S rRNA highthroughput sequencing.Spearman rank correlation analysis was used to evaluate the correlation between intestinal flora dysbiosis and cardiac hemodynamic parameters,including cardiac output and left ventricular end-diastolic volume.Results There were significant differences in the structure of intestinal flora between the heart failure group and the healthy control group.The abundance of Lactobacillus in patients with heart failure was significantly reduced(8.02%±3.43%vs.10.48%±2.83%;P<0.05),and the abundance of Clostridium perfringens was also reduced(8.05%±3.29%vs.10.07%±3.06%;P<0.05),the abundance of Bacteroidetes increased significantly(10.32%±3.69%vs.9.22%±2.53%;P<0.05).Left ventricular end-diastolic volume(EDV)in patients with heart failure was positively correlated with the abundance of Clostridium(P<0.05),and negatively correlated with the abundance of Bacteroides,Lactobacillus,and Clostridium perfringens.Systemic vascular resistance(SVR)was negatively correlated with the abundance of several genera such as Bacteroides and Lactobacillus(P<0.05).Conclusion Intestinal flora dysbiosis is significantly related to cardiac hemodynamic parameters in patients with heart failure,suggesting that changes in intestinal microbial composition may play an important role in the pathogenesis of heart failure.These results highlight the importance of further investigat

关 键 词：心力衰竭 肠道微生物群 血流动力学 16S rRNA基因测序 

分 类 号：R541.6[医药卫生—心血管疾病]