老年冠心病合并心力衰竭患者肠道菌群特征性研究

Characteristics of intestinal flora in the elderly patients with coronary heart disease versus coronary heart disease-complicated heart failure

目的观察老年冠心病及合并心力衰竭(心衰)患者肠道菌群的临床特征。方法前瞻性研究,连续入选2017年4月至2018年4月至郑州大学第五附属医院就诊的老年冠心病患者40例(冠心病组),冠心病合并心力衰竭(心衰)老年患者40例(合并心衰组);选择同期体检科健康体检老年人40例(对照组)。留取入选者大便约0.5 g,提取粪便总DNA,对16S rDNA/18S rDNA/ITS/功能基因等特定区段聚合酶链(PCR)扩增并对产物进行高通量测序,测序结果经过Read拼接,操作单元分类(OTU)聚类,α多样性分析和物种差异分析,最终得出样本物种信息。结果老年冠心病组和合并心衰组患者肠道菌群丰度低于对照组(均P<0.05)。拟杆菌门丰度对照组为(66.41±3.25)%,高于冠心病组和合并心衰组患者的(45.21±9.07)%、(27.29±13.27)%(均P<0.05);厚壁菌门丰度对照组人群低于冠心病组和合并心衰组患者(均P<0.05)。LEfSe分析结果显示,对照组丰度较高的菌群主要为拟杆菌门、拟杆菌纲及拟杆菌目。冠心病组丰度较高的菌群为瘤胃球菌属、梭菌属。合并心衰组患者丰度较高的菌群为厚壁菌门及肠杆菌属。结论老年冠心病及冠心病合并心衰患者存在肠道菌群紊乱。

Objective To investigate characteristics of intestinal flora in elderly patients with coronary heart disease(CHD)versus CHD plus complicated heart failure(HF).Methods The 80 CHD patients admitted into our hospital from April 2017 to April 2018 were consecutively enrolled in this prospective study.They were divided into the CHD group(without HF,n=40)and the HF group(CHD plus HF,n=40),and 40 healthy elderly people taking health examination during the same period were considered as the control group.The 0.5 g stool specimen from each observer was collected.The specific DNA fragments of 16S rDNA/18S rDNA/ITS/function genes were amplified,the Polymerase Chain reaction(PCR)amplified products were sequenced by Illumina Genome Analyzer IIx.And the sequencing results were followed by Read splicing,OTU clustering,alpha diversity analysis and species diversity analysis.Finally,the sample species information was obtained.Results The mean abundances of gut microflora in CHD group and in HF group were lower than in control group(P<0.05).The abundance of phylum bacteroidetes was higher in the control group(66.41±3.25)%than in the CHD group(45.21±9.07)%and in HF groups(27.29±13.27)%(P<0.05).And the abundance of phylum firmicutes was lower in the control group than in the CHD and HF groups(P<0.05).LEfSe analysis showed that the flora with high abundances in the healthy elderly group were mainly Bacteroides,Bacteroidia and Bacteroidales.Ruminococcus and Clostridium occurred mainly in the CHD group,and Firmicutes and Enterobacte occurred mainly in CHD plus heart failure group.Conclusions The intestinal flora disturbance occurs in elderly patients with coronary heart disease or CHD with heart failure.