急性心肌梗死患者肠道菌群多样性分析

目的 初步探究急性心肌梗死患者肠道菌群的多样性。方法 选择2015年6月至2016年3月于大连大学附属中山医院住院治疗的急性心肌梗死患者作为观察组，年龄51~70岁。选择同期经冠脉造影排除冠心病的住院患者为对照组，年龄51~70岁。排除近1个月内发生感染、炎性肠病及应用抗生素的患者。所有患者按性别与年龄分为A、B、C、D组。直接从患者粪便标本中提取细菌总DNA，PCR扩增后进行梯度凝胶电泳（DGGE）分析。结果 DGGE分析显示急性心梗患者肠道菌群丰度均较对照组下降。A组中观察组与对照组患者电泳条带数为(33.71±4.39) vs (38.71±2.56)，t=－2.058，P=0.040；C组患者为(31.14±2.67) vs (35.29±3.55)，t=－2.005，P=0.045；差异均具有统计学意义。B与D组中心梗患者肠道菌群丰度亦有下降趋势，但与对照组比差异无统计学意义。UPGAM法聚类分析显示除D组外，各组中观察组与对照组患者肠道菌群呈现分离现象；急性心梗患者肠道菌群有较高相似性，与非冠心病患者肠道菌群差异明显。结论 急性心梗与非冠心病患者肠道菌群存在差异，急性心梗患者肠道菌群多样性较低。肠道菌群改变可能与急性心肌梗死存在一定相关性。

The diversity of intestinal flora in patients with acute myocardial infarction

Objective To preliminarily explore the diversity of intestinal flora in patients with acute myocardial infarction. Methods Acute myocardial infarction (AMI) patients at ages of 51 to 70 in our hospital from Jun 2015 to Mar 2016 were selected as the observation group. Patients who were ruled out of coronary heart disease by coronary angiography hospitalized in the same period, also in the same age range, were selected as the control group. Patients who had infections and inflammatory bowel disease and accepted antibiotics within the last month were excluded. All the patients were divided into four groups based on gender and age. The total bacterial DNA was extracted from the stool specimen. After PCR amplification, DGGE analysis was performed. Results The diversity of intestinal flora in AMI patients decreased compared with the control group. There were significant differences in the number of bands in group A (33.71±4.39 vs 38.71±2.56, t=-2.058, P=0.040) and group C (31.14±2.67 vs 35.29±3.55, t=-2.005, P=0.045). The abundances of intestinal flora in group B and group D also showed a downward trend but without statistical difference. UPGAM clustering analysis showed that all the groups, except group D, demonstrated apparent separation between the observation group and control group. The intestinal flora of AMI patients had higher similarity, whereas the intestinal flora of patients without coronary heart disease had greater diversity. Conclusion The diversity of the intestinal flora between AMI patients and those without coronary artery disease are significantly different. The former is relatively low. The change in intestinal flora may have a certain correlation with AMI.