摘要
目的:观察慢性肾脏病(CKD)3~5期患者肠道菌群改变,并分析其与心功能的关系。方法:选取医院2022年1月-2023年10月收治的CKD 3~5期患者(观察组)和健康志愿者(对照组),各180例。采用16S核糖体脱氧核糖核酸(16S rDNA)高通量测序技术检测2组肠道菌群属相对丰度,采用超声心动图检测2组心功能,并比较2组上述指标。比较观察组不同CKD分期患者肠道菌群属相对丰度和心功能;Pearson法分析观察组肠道菌群改变与心功能的关系。结果:观察组梭杆菌属、双歧杆菌属相对丰度、左室射血分数(LVEF)均低于对照组(P<0.05),且CKD 4和5期均低于CKD 3期(P<0.05),CKD 5期均低于CKD 4期(P<0.05);观察组丁酸弧菌属、克雷伯氏菌属、肠球菌属、韦荣氏球菌属、巨单胞菌属相对丰度、二尖瓣舒张早期血流峰值/二尖瓣环舒张早期运动速度(E/E’)、左室内径(LVD)、左室质量指数(LVMI)均高于对照组(P<0.05),且CKD 4和5期均高于CKD 3期(P<0.05),CKD 5期均高于CKD 4期(P<0.05);CKD 4和5期罕见小球菌属、毛螺菌属相对丰度均低于CKD 3期(P<0.05),且CKD 5期均低于CKD 4期(P<0.05),CKD 5期布劳特氏菌属相对丰度均低于CKD 3和4期(P<0.05);CKD 4期和5期患者室间隔厚度(IVSD)均高于CKD 3期(P<0.05),且CKD 5期高于CKD 4期(P<0.05);梭杆菌属、布劳特氏菌属、双歧杆菌属、罕见小球菌属、毛螺菌属相对丰度与LVEF呈正相关(P<0.05),与E/E’、IVSD、LVD、LVMI呈负相关(P<0.05);丁酸弧菌属、克雷伯氏菌属、肠球菌属、韦荣氏球菌属、巨单胞菌属相对丰度与LVEF呈负相关(P<0.05),与IVSD、E/E’、LVD、LVMI呈正相关(P<0.05)。结论:CKD 3~5期患者梭杆菌属、双歧杆菌属减少,丁酸弧菌属、克雷伯氏菌属等增加,且有心功能改变,分期越高肠道菌群与心功能改变越严重,且肠道菌群属水平与心功能有关。
Objective:To observe the changes in gut microbiota in patients with chronic kidney disease(CKD)stages 3~5 and to analyze their relationships with cardiac function.Methods:180 CKD stage 3~5 patients(observation group)and 180 healthy volunteers(control group)admitted to the hospital from January 2022 to October 2023 were enrolled.16S ribosomal deoxyribonucleic acid(16S rDNA)high-throughput sequencing technology was used to detect the relative abundance of two groups of gut microbiota.Echocardiography was used to detect heart function in two groups and compare the above indicators between the two groups.The relative abundances of gut microbiota and cardiac function in patients were compared among different CKD stages in the observation group.Pearson method was used to analyze the relationships between changes in gut microbiota and cardiac function in the observation group.Results:The relative abundances of Fusobacterium,Bifidobacterium and left ventricular ejection fraction(LVEF)in the observation group were lower than those in the control group(P<0.05),of which in CKD stage 4 and 5 were lower than those stage 3(P<0.05),and those in stage 5 were lower than those stage 4(P<0.05).The relative abundances of Anaerostipes,Klebsiella,Enterococcus,Veillonella and Megamonas,peak early diastolic blood flow of mitral valve/early diastolic motion velocity of mitral annulus(E/E’),left ventricular diameter(LVD),left ventricular mass index(LVMI)in the observation group were higher than those in the control group(P<0.05),of which in CKD stage 4 and 5 were higher than those stage 3(P<0.05),and those in stage 5 were higher than those stage 4(P<0.05).The relative abundances of Subdoligramulum,Lachnospira in CKD stage 4 and 5 were lower than those stage 3(P<0.05),and those in stage 5 were lower than those stage 4(P<0.05).The relative abundance of Blautia in CKD stage 5 was lower than those in stage 3 and 4(P<0.05).Interventricular septal thickness(IVSD)in CKD stage 4 and 5 were higher than that stage 3(P<0.05),of which in stage 5 was higher than that stage 4(P<0.05).The relative abundance of Fusobacterium,Blautia,Bifidobacterium,Subdoligramulum,Lachnospira were positively related to LVEF(P<0.05),which were negatively related to E/E’,IVSD,LVD and LVMI(P<0.05).The relative abundance of Anaerostipes,Klebsiella,Enterococcus,Veillonella,Megamonas were negatively related to LVEF(P<0.05),which were positively related to IVSD,E/E’,LVD and LVMI(P<0.05).Conclusion:CKD stage 3~5 patients have a decrease in Fusobacterium,Bifidobacterium,an increase in Anaerostipes,Klebsiella etc.,and changes in heart function.The higher the stage,the more severe the changes in gut microbiota and heart function,and the levels of gut microbiota are related to heart function.
作者
邓靖怡
李含含
王大鑫
DENG Jingyi;LI Hanhan;WANG Daxin(Department of Clinical Laboratory,the Third People’s Hospital of He’nan Province,Zhengzhou City,He’nan Province 450000;不详)
出处
《医学理论与实践》
2024年第18期3077-3080,共4页
The Journal of Medical Theory and Practice
关键词
慢性肾脏病
肠道菌群
心功能
Chronic kidney disease
Intestinal microbiota
Cardiac function
