不同心血管危险分层高血压患者肠道菌群多样性分析

Analysis of gut microbiota diversity in people with different cardiovascular risk stratified of hypertension

目的探讨不同心血管危险分层高血压患者中肠道菌群的变化特征及其对心血管事件发生风险的预测价值。方法收集20～85岁的原发性高血压患者85例,根据2018年欧洲高血压指南,将患者分为高血压低中危组、高危组和很高危组,采用16S rDNA高通量测序技术检测各组患者肠道菌群组成及丰度的改变,并分析其与Score评分的相关性。结果不同危险分层的高血压患者,其肠道微生物的α多样性差异没有统计学意义(P> 0.05),相对丰度差异有统计学意义(P <0.05)。与低中危组相比,很高危组及高危组患者肠道罗斯氏菌和Anaerostipes菌的相对丰度显著降低,而放线菌、瘤胃球菌、毛螺旋菌、嗜胆菌和SMB53在很高危组患者中的相对丰度显著低于高危组和低中危组。此外,通过Spearman相关系数分析发现克雷伯氏菌属和颤螺旋菌属丰度与Score评分呈正相关,而罗斯氏菌属和毛螺旋菌属丰度与Score评分呈负相关(P <0.05)。结论不同心血管危险分层的高血压患者肠道菌群结构及相对丰度存在显著差异,随着心血管危险程度的提高,患者肠道内益生菌丰度显著降低,提示肠道微生物可能参与高血压疾病进程。

Objective To investigate the changes of gut microbiota in patients with different cardiovascular risk stratified of hypertension and its predictive value for cardiovascular risk. Methods Eighty-five patients with primary hypertension were collected from 20 to 85 years old. According to the 2018 European Hypertension Guidelines,patients were divided into low Intermediate-risk group,high-risk group and very high-risk group. The 16S rDNA high-throughput sequencing technology was used to detect the changes in gut microbiota composition and abundance of each group,and the correlation with Score value was analyzed. Results There was no statistically significant difference in the alpha diversity of gut microbiota in hypertensive patients with different risk stratification(P > 0.05), and there was significant difference in relative abundance(P < 0.05). Compared with the low Intermediate-risk group,the relative abundances of Roseburia and Anaerostipes were significantly lower in the very high-risk group and the high-risk group, while the relative abundances of Actinomyces, Ruminococcus, Lachnospira, Bilophila and SMB53 in the very high-risk group were significantly lower than those in the high-risk group and the low Intermediate-risk group. In addition,spearman correlation coefficient analysis showed that the abundance of Klebsiella and Oscillospira were positively correlated with Score value,w hile the abundance of Roseburia and Lachnospira were negatively correlated with Score value(P < 0.05). Conclusion There are significant differences in the structure and relative abundance of gut microbiota between hypertensive patients with different cardiovascular risk stratification. With the increase of cardiovascular risk,the abundance of probiotics in the intestines of patients is significantly reduced,suggesting that gut microbes may be involved in the progression of hypertension.