肠道菌群失调与抑郁症合并冠心病预后的相关性

摘要 目的：探讨肠道菌群失调与抑郁症合并冠心病的相关性，并分析肠道菌群失调对抑郁症合并冠心病预后的预测价值。方法：选取我院2021年6月到2022年5月收治的80例抑郁症患者作为研究对象，将单纯抑郁症的49例患者分为抑郁症组，将合并冠心病的31例患者分为l联合组，另选取同期来我院体检的40名健康者分为对照组，对比三组患者肠道菌群情况，应用Spearman相关分析分析肠道菌群失调与抑郁症合并冠心病的相关性。随后，对31例抑郁症合并冠心病患者进行随访，将其分为预后良好组（n=21）和预后不良组（n=10），对比两组患者临床一般情况与肠道菌群情况，应用logistic回归分析分析肠道菌群对抑郁症合并冠心病的预后预测价值。结果：三组患者拟杆菌情况无明显差异（P＞0.05），肠杆菌、肠球菌、双歧杆菌、乳杆菌和双歧杆菌属与肠杆菌科细菌数量比（B/E）值对比差异显著，l联合组肠杆菌、肠球菌明显高于抑郁症组和对照组，双歧杆菌、乳杆菌、B/E值明显低于抑郁症组和对照组（P＜0.05）；Spearman相关分析结果显示：肠道菌群失调中拟杆菌水平与抑郁症合并冠心病无明显相关性（P＞0.05），肠道菌群失调中肠杆菌、肠球菌水平与抑郁症合并冠心病呈正相关，与双歧杆菌、乳杆菌和双歧杆菌属与肠杆菌科细菌数量的对数值比（B/E）值呈负相关（P＜0.05）；预后良好组与预后不良组、年龄、BMI、合并基础疾病、hs-cTnT、NT-proBNP、NT-proBNP、PHQ-9评分、拟杆菌对比无明显差异（P＞0.05），hs-CRP、肠杆菌、肠球菌、双歧杆菌、乳杆菌、B/E值对比差异显著（P＜0.05）；logistic回归分析结果表明：只有hs-CRP和B/E值菌群失调对于抑郁症合并冠心病的预后具有独立预测价值（P＜0.05）。结论：抑郁症合并冠心病患者较单一抑郁症和健康者来说肠道菌群比例出现失调，且肠道菌群失调与抑郁症合并冠心病呈明显相关性，应用B/E 值可对抑郁症合并冠心病患者预后情况进行预测。

Correlation between Intestinal Flora Imbalance and Prognosis of Depression with Coronary Heart Disease

ABSTRACT Objective: To investigate the correlation between intestinal flora imbalance and depression with coronary heart disease, and analyze the predictive value of intestinal flora imbalance on the prognosis of depression with coronary heart disease. Methods: 80 patients with depression admitted to our hospital from June 2021 to May 2022 were selected as the research objects. 49 patients with simple depression were divided into depression group, 31 patients with coronary heart disease were divided into depression and coronary heart disease group, and 40 healthy people who came to our hospital for physical examination at the same time were selected as the control group to compare the intestinal flora of the three groups, Spearman correlation analysis was used to analyze the correlation between intestinal flora imbalance and depression with coronary heart disease. Subsequently, 31 patients with depression and coronary heart disease were followed up, and they were divided into good prognosis group (n=21) and poor prognosis group (n=10). The clinical general conditions and intestinal flora of the two groups were compared, and the prognostic value of intestinal flora for depression and coronary heart disease was analyzed by logistic regression analysis. Results: There was no difference in Bacteroides among the three groups (P>0.05). There was a difference in the comparison of Enterobacteriaceae, Enterococcus, Bifidobacterium, Lactobacillus and B/E values. The levels of Enterobacteriaceae and Enterococcus in the depression with coronary heart disease group were higher than those in the depression group and the control group, and the values of Bifidobacterium, Lactobacillus and B/E were lower than those in the depression group and the control group (P<0.05); Spearman correlation analysis showed that there was no significant correlation between the level of Bacteroides in intestinal dysbacteriosis and depression with coronary heart disease (P>0.05). The levels of Enterobacteriaceae and Enterobacteriaceae in intestinal dysbacteriosis were positively correlated with depression with coronary heart disease, and negatively correlated with the logarithmic ratio (B/E) of the number of Bifidobacterium, Lactobacillus, Bifidobacteriaceae and Enterobacteriaceae (P<0.05); There was no difference in the scores of hs cTnT, NT proBNP, NT proBNP, PHQ-9 and Bacteroides between the group with good prognosis and the group with poor prognosis, age, BMI, concomitant basic diseases(P>0.05), but there was difference in hs CRP, Enterobacteriaceae, Enterococcus, Bifidobacterium, Lactobacillus and B/E values(P<0.05); Logistic regression analysis showed that only hs CRP and B/E value dysbacteriosis had independent predictive value for the prognosis of depression with coronary heart disease(P<0.05). Conclusion: The proportion of intestinal flora in patients with depression combined with coronary heart disease is more imbalance than that in patients with single depression and healthy people, and the imbalance of intestinal flora is significantly related to depression combined with coronary heart disease. The application of B/E value can predict the prognosis of patients with depression combined with coronary heart disease.