不同临床分型冠心病患者的肠道菌群多样性分析

Analysis of gut microbiota diversity in patients with different clinical subtypes of coronary artery disease

目的探究不同临床分型冠心病患者与健康人群肠道菌群结构差异。方法于2017年6月至2018年3月收集48例稳定性心绞痛、48例不稳定性心绞痛、30例非ST段抬高型心梗、41例ST段抬高型心梗冠心病患者及41例健康受试者的粪便样本,利用16S rDNA高通量测序技术检测其肠道菌群组成及丰度的变化。结果 5组受试者肠道菌群β多样性差异有统计学意义(P <0.001),表明5组受试者菌群结构差异有统计学意义。相比健康人群,ST段抬高型心梗患者变形菌门显著增高(P <0.001),4组冠心病患者放线菌门均显著增高(P <0.01)。相比健康人群,4组冠心病患者链球菌属、考拉杆菌属、埃希氏菌属均显著增高(P <0.05),萨特氏菌属、粪厌氧棒状菌属和罗氏菌属均显著降低(P <0.05),非ST段抬高型心梗和ST段抬高型心梗组患者颗粒链菌属显著增高(P <0.01),ST段抬高型心梗患者克雷伯氏菌属显著增高(P <0.001)。结论不同临床分型冠心病患者与健康人群肠道菌群结构均存在差异,提示肠道菌群可能参与冠心病疾病进展。

Objective The purpose of this study was to investigate the differences of gut microbiota between patients with different clinical subtypes of coronary artery disease and healthy people.Methods CAD parents were enrolled from June 2017 to March 2018 and divided intothe four groups:SA group(n=48),UA group(n=48),NSTMI group(n=30)and STEMI group(n=41).Meanwhile,43 healthy people were selected as the control group.16S rDNA high⁃throughput sequencing technology was used to analyze the composition and abundance of gut microbiota.Results There was statistically significant difference in the beta diversity of gut microbiota among the 5 groups of subjects(P<0.001).Compared with control group,Proteobacteria in the STEMI group were significantly higher(P<0.001)and Actinobacteria in the four CAD groups were significantly higher(P<0.01)than control group.The abundance of Streptococcus,Phascolarctobacterium and Escherichia in the four CAD groups was significantly higher than the control group(P<0.05),while Sutterella,Anaerostipes and Rothia significantly decreased(P<0.05).Compared to the control group,Granulicatella in the NSTEMI and STEMI groups were significantly high(P<0.01)and Klebsiellain the STEMI group were significantly high(P<0.001).Conclusion There was significant difference in the structure of gut microbiota between patients with different clinical subtypes of CAD and healthy human,suggesting that gut microbiota might involved in the progression of coronary artery disease.