氧化三甲胺与心力衰竭患者肠道菌群及预后的相关性研究

Study on the correlation between trimethylamine oxide and gut microbiota and prognosis in patients with heart failure

目的分析氧化三甲胺(TMAO)与心力衰竭患者肠道菌群及预后情况的相关性。方法选取122例心力衰竭患者的临床资料,将TMAO≥2.58μmol/L的42例患者列为高水平组,TMAO<2.58μmol/L的80例患者列为低水平组。比较两组肠道菌群检测结果,分析TMAO水平与肠道菌群相关参数的关联性,统计入组患者不良预后发生情况,比较两组TMAO及肠道菌群参数间的差异,分析TMAO对心力衰竭患者不良预后的预测效能。结果高水平组的肠道菌落丰富度(Chao指数),肠道菌群多样性(Shannon指数),肠道菌群的操作分类单元聚类值(OTUs),沙门菌、志贺菌、念珠菌的浓度均低于低水平组,柯林斯菌浓度、布劳特菌的浓度均高于低水平组,差异均具有统计学意义(P<0.05)。TMAO与Chao指数,Shannon指数,OTUs、沙门菌、志贺菌、念珠菌的浓度呈负相关,与柯林斯菌浓度、布劳特菌的浓度呈正相关(P<0.05);TMAO水平对心力衰竭的不良预后具有较高预测效能(ACU>0.85)。结论TMAO水平与心力衰竭患者肠道菌群及预后具有一定相关性,且TMAO水平越高,患者不良预后发生率越高。

Objective To analyze the correlation between trimethylamine oxide(TMAO)and gut microbiota and prognosis in patients with heart failure.Methods Selecting clinical data from 122 patients with heart failure,42 patients with with TMAO≥2.58μmol/L were classified as the high-level group,80 patients with TMAO<2.58μmol/L were classified as the low-level group.The results of gut microbiota detection between the two groups were compared,and the correlation between TMAO levels and gut microbiota related parameters was analyzed,statistically analyze the occurrence of adverse prognosis in enrolled patients,compare the differences in TMAO and gut microbiota parameters between the two groups,and verify the predictive efficacy of TMAO for adverse prognosis in heart failure patients.Results The richness of gut microbiota(Chao index),diversity of gut microbiota(Shannon index),clustering values of operational taxonomic units(OTUs)of gut microbiota,and concentrations of Klebsiella and Brucella in the high-level group were all lower than those in the low-level group.The concentrations of Salmonella,Shigella,and Candida were all higher than those in the low-level group,showing a statistically significant difference(P<0.05).TMAO is positively correlated with the concentrations of Salmonella,Shigella,and Candida,but negatively correlated with the concentrations of Chao index,Shannon index,OTUs,Corinthia,and Brucella(P<0.05).TMAO levels have a high predictive power for poor prognosis of heart failure(ACU>0.85).Conclusion There is a certain correlation between TMAO levels and gut microbiota and prognosis in patients with heart failure,and the higher the TMAO level,the higher the incidence of adverse prognosis in patients.