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慢性肾衰竭合并冠心病患者肠道菌群变化及其与动脉僵硬度指数的相关性

Changes in Intestinal Flora From Chronic Renal Failure Complicated With Coronary Heart Disease and its Correlation With Arterial Stiffness Index.

作者信息

Zheng Xijie, Li Jiandong, Gou Yanli, Guo Shanshan, Zhang Yapu, Gong Youlan, Chen Hang

出版信息

Altern Ther Health Med. 2023 Jan;29(1):252-257.

Abstract

CONTEXT

One common and serious cardiovascular complication of chronic renal failure (CRF) is coronary heart disease (CHD). CRF can lead to an imbalance of patients' gut microbiota, and changes in intestinal flora might heavily affect CRF's development.

OBJECTIVE

The study intended to investigate the changes in intestinal flora of patients with CRF complicated with CHD and their relationship with ASI to understand the association of those changes and ASI with CRF comorbid with CHD, with the goal of offering a reliable clinical basis for active prevention and treatment of CRF and CHD in the future.

DESIGN

The research team designed a prospective controlled study.

SETTING

The study took place at the Affiliated Hospital of Hebei University in Baoding, Hebei, China.

PARTICIPANTS

Participants were 86 patients with both CRF and CHD and 72 patients with CHD only who had been admitted to the hospital between October 2019 and January 2021.

INTERVENTION

The intervention group included participants who had received a diagnosis of CRF complicated with CHD and the control group included participants who had received a diagnosis of CHD only.

OUTCOME MEASURES

The research team counted participants' intestinal flora and measured their ambulatory blood pressure and arterial stiffness index (ASI) to analyze the correlation of the ASI with the intestinal flora and the related factors impacting CHD in patients with CRF.

RESULTS

The monitoring of participants' ambulatory blood pressures showed that the intervention group's day systolic blood pressure (dSBP) and 24h SBP were significantly higher, while the group's day diastolic blood pressure (dDBP) and 24h DBP were significantly lower than those of the control group. The intervention group's levels of lactobacillus, bacteroidaceae, and bifidobacterium were significantly lower than those of the control group, and those intestinal flora were negatively correlated with ASI. The intervention group's levels of Escherichia coli and yeasts were significantly higher than those of the control group, and those intestinal flora were positively correlated with ASI. A significant relationship existed between lactobacillus and yeast and the occurrence of CHD in the CRF participants.

CONCLUSIONS

Patients with both CRF and CHD have an obvious intestinal-flora imbalance, and the imbalance is strongly bound up with their ASI, which is of great reference significance for novel therapy of such patients and for the clinical application of ASI.

摘要

背景

慢性肾衰竭(CRF)常见且严重的心血管并发症是冠心病(CHD)。CRF可导致患者肠道微生物群失衡,肠道菌群变化可能严重影响CRF的发展。

目的

本研究旨在探讨CRF合并CHD患者肠道菌群的变化及其与动脉僵硬度指数(ASI)的关系,以了解这些变化及ASI与CRF合并CHD的关联,为未来积极预防和治疗CRF及CHD提供可靠的临床依据。

设计

研究团队设计了一项前瞻性对照研究。

地点

研究在中国河北保定的河北大学附属医院进行。

参与者

参与者为2019年10月至2021年1月期间入院的86例CRF合并CHD患者和72例单纯CHD患者。

干预

干预组包括被诊断为CRF合并CHD的参与者,对照组包括仅被诊断为CHD的参与者。

观察指标

研究团队对参与者的肠道菌群进行计数,并测量其动态血压和动脉僵硬度指数(ASI),以分析ASI与肠道菌群的相关性以及影响CRF患者CHD的相关因素。

结果

对参与者动态血压的监测显示,干预组的日间收缩压(dSBP)和24小时收缩压显著更高,而该组的日间舒张压(dDBP)和24小时舒张压显著低于对照组。干预组的乳酸杆菌、拟杆菌科和双歧杆菌水平显著低于对照组,且这些肠道菌群与ASI呈负相关。干预组的大肠杆菌和酵母菌水平显著高于对照组,且这些肠道菌群与ASI呈正相关。乳酸杆菌和酵母菌与CRF参与者CHD的发生存在显著关系。

结论

CRF合并CHD患者存在明显的肠道菌群失衡,且该失衡与他们的ASI密切相关,这对这类患者的新疗法及ASI的临床应用具有重要参考意义。

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