冠状动脉粥样硬化患者肠道菌群与嘌呤碱基分解代谢的相关性

目的 研究冠状动脉粥样硬化患者肠道菌群结构与嘌呤碱基分解代谢的相关性。方法 选取2016年12月至2019年4月我院收治的92例冠状动脉粥样硬化患者为研究对象，测定患者嘌呤碱基代谢物含量并按照不同嘌呤碱基代谢物水平分为I组（22例，代谢物水平≤430 μmol/L）、II组（24例，代谢物水平431~480 μmol/L）、III组（22例，代谢物水平481~530 μmol/L）、IV组（24例，代谢物水平＞530 μmol/L）。选取同期到我院体检的30例健康者为对照组。采用实时荧光定量PCR法检测两组对象肠道菌群数量，采用OTU聚类分析肠道菌群多样性。肠道菌群结构与嘌呤碱基分解代谢的相关性分析采用Pearson分析。结果 I~IV组患者嘌呤碱基代谢物水平、肠道菌群总量依次升高，差异有统计学意义（均P＜0.05），同时各组冠状动脉脉粥样硬化患者嘌呤碱基代谢物水平、肠道菌群总量均高于对照组，差异有统计学意义（均P＜0.05）。IV组患者肠道大肠埃希菌数量高于I组、II组、III组及对照组（均P＜0.05）。IV组患者肠道幽门螺杆菌、产气杆菌数量高于I组、II组及对照组，而肠道乳杆菌、双歧杆菌数量低于I组、II组及对照组（均P＜0.05）。III组患者肠道幽门螺杆菌、产气杆菌数量高于I组，而乳杆菌、双歧杆菌数量低于I组（均P＜0.05）。III组患者肠道幽门螺杆菌、乳杆菌、双歧杆菌数量均低于对照组（均P＜0.05）。II组患者肠道产气芽胞杆菌数量高于对照组，而乳杆菌、双歧杆菌数量低于对照组（均P＜0.05）。IV组、III组患者肠道菌群OTU指数均高于对照组、I组和II组，差异均有统计学意义（均P＜0.05），说明IV组、III组患者肠道菌群丰富度指数较高，菌群种类较多。Pearson分析显示嘌呤碱基水平与大肠埃希菌、幽门螺杆菌、产气芽胞杆菌、乳杆菌和双歧杆菌呈现正相关性（P＜0.05）。结论 冠状动脉粥样硬化患者嘌呤碱基水平可能影响肠道菌群结构。

Correlation between intestinal flora structure and purine catabolism in patients with coronary atherosclerosis

Objective To explore the correlation between intestinal flora structure and purine catabolism in patients with coronary atherosclerosis. Methods A total of 92 patients with coronary atherosclerosis admitted to our hospital from December 2016 to April 2019 were enrolled and divided into group I (22 cases,metabolite contents≤430 μmol/L), group II (24 cases, metabolite contents 431 – 480 μmol/L), group III (22 cases, metabolite contents 481 – 530 μmol/L) or group IV (24 cases, metabolite contents >530 μmol/L) according to different metabolite levels. 30 healthy people who received physical exam in our hospital in the same period were enrolled as the control group. The number of intestinal flora was detected using real-time quantitative PCR, OTU cluster analysis was used to analyze the diversity of intestinal flora in different groups, and Pearson method was used to analyze the correlation between intestinal flora structure and purine catabolism. Results The purine level and total bacterial count increased in turn fromin group I to group IV with significant difference between groups (all P<0.05), and were significantly higher than in the control group (all P<0.05). The amount ofEscherichia coliin group IV was higher than in groups I, II and III and control group (all P<0.05). The amounts of Helicobacter pylori and Aerobacter aerogenes in group IV were higher, while those of intestinal Lactobacilli and Bifidobacteria were lower than in groups I and II group and control group (all P<0.05) respectively. The amounts of Helicobacter pylori and Aerobacter aerogenesin group III were higher, while those of Lactobacilli and Bifidobacteria were lower than in group I (all P<0.05) respectively. The amounts of Helicobacter pylori, Lactobacilli and Bifidobacteria in group III were lower than those in the control group (all P<0.05). The amount of Aerobacter aerogenes in group II was higher, while those of Lactobacilli and Bifidobacteria were lower than in the control group (all P<0.05) respectively. The OTU indexes in group IV and group III were significantly higher than in control group, group I and group II (all P<0.05) respectively, indicating high abundance indexes of intestinal flora and more types of bacteria in group IV and group III. Pearson analysis showed that the level of purine was positively associated with Escherichia coli, Helicobacter pylori, Aerobacter aerogenes, Lactobacillus and Bifidobacteria (all P<0.05). Conclusion The level of purine in patients with coronary atherosclerosis may affect the structure of intestinal flora.