慢性阻塞性肺疾病肠道微生态与炎症因子及临床指标的相关性

Correlation of intestinal micro-ecology with inflammatoryfactors and clinical indicators inchronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD,简称慢阻肺)肠道微生态与炎症因子及临床指标的相关性。方法纳入慢阻肺急性加重患者(A组)、慢阻肺稳定期(S组)以及正常对照组(N组)各30例。收集患者临床资料,测定血清炎症因子,留取粪便标本,通过16SV3+4区引物进行细菌多样性的鉴定,采用线性判别分析效应量(LEfSe)找出3组的差异菌,用冗余分析(RDA)研究差异菌与炎症因子及临床指标的相关性。结果A组中,霍氏真杆菌、Anaerostipes菌、毛螺旋菌属、双歧杆菌等与炎症因子及临床指标均呈负相关,而与肺功能呈正相关;而普雷沃菌-9、肠球菌、Lachnoclostridium菌等却相反;在S组与N组中,双歧杆菌、Fusicatenibacter菌等与气道炎症因子呈负相关,而与FEV1呈正相关,而Lachnoclostridium菌则同样得出相反的结果。结论霍氏真杆菌、双歧杆菌、Anaerostipes菌等或许可减轻慢阻肺患者炎症,而普雷沃菌-9、肠球菌、Lachnoclostridium菌等则可能与慢阻肺急性加重和临床指标的恶化有关。

Objective To explore the correlation between intestinal micro-ecology of chronic obstructive pulmonary disease(COPD)and inflammatory factors and clinical indicators.Methods To recruit the patients with acute exacerbation of COPD(group A)and COPD stable phase(Group S)and normal control group(group N)30 cases each.The clinical data of the patients were collected,serum inflammatory factors were measured,feces specimens were retained,and the bacterial diversity was identified by 16 SV3+4 region primers.The linear discriminant analysis effect amount(LEfSe)was used to identify the three groups of differential bacteria,and multivariate direct gradient analysis(RDA)was used to study the correlation between the differential bacteria and inflammatory factors and clinical indicators.Results In group A,[Eubacterium]halliigroup,Anaerostipes,Lachnospira,Bifidobacterium,Blautia,etc.were negatively related to inflammatory factors and clinical indicators,and positively related to lung function;while Prevotell9,Enterococcus,Lachnoclostridium,etc.were the opposite.in S and N groups,Bifidobacterium,Fusicatenibacter,etc.were negatively related to airway inflammatory factors,and positively correlated with FEV1,while Lachnoclostridium bacteria also have the opposite result.Conclusions[Eubacterium]halliigroup,Anaerostipes,Bifidobacterium,and other flora may reduce inflammation in patients with COPD While Prevotell9,Enterococcus,Lachnoclostridium,etc.may be related to the acute exacerbation of COPD and the deterioration of clinical indicators.