Efremova Irina, Maslennikov Roman, Poluektova Elena, Zharkova Maria, Kudryavtseva Anna, Krasnov George, Fedorova Maria, Shirokova Elena, Kozlov Evgenii, Levshina Anna, Ivashkin Vladimir
Department of Internal Medicine, Gastroenterology and Hepatology, Sechenov University, 119991 Moscow, Russia.
The Interregional Public Organization "Scientific Community for the Promotion of the Clinical Study of the Human Microbiome", 119991 Moscow, Russia.
Microorganisms. 2023 Aug 31;11(9):2202. doi: 10.3390/microorganisms11092202.
The aim was to evaluate the relationship between gut dysbiosis and hemodynamic changes (hyperdynamic circulation) in cirrhosis, and between hemodynamic changes and complications of this disease. This study included 47 patients with cirrhosis. Stool microbiome was assessed using 16S rRNA gene sequencing. Echocardiography with a simultaneous assessment of blood pressure and heart rate was performed to assess systemic hemodynamics. Patients with hyperdynamic circulation had more severe cirrhosis, lower albumin, sodium and prothrombin levels, higher C-reactive protein, aspartate aminotransferase and total bilirubin levels, and higher incidences of portopulmonary hypertension, ascites, overt hepatic encephalopathy, hypoalbuminemia, hypoprothrombinemia, systemic inflammation, and severe hyperbilirubinemia than patients with normodynamic circulation. Patients with hyperdynamic circulation compared with those with normodynamic circulation had increased abundance of Proteobacteria, Enterobacteriaceae, Bacilli, Streptococcaceae, Lactobacillaceae, Fusobacteria, Micrococcaceae, Intestinobacter, Clostridium sensu stricto, Proteus and Rumicoccus, and decreased abundance of Bacteroidetes, Bacteroidaceae, Holdemanella, and Butyrivibrio. The systemic vascular resistance and cardiac output values correlated with the abundance of Proteobacteria, Enterobacteriaceae, Bacilli, Streptococcaceae, Lactobacillaceae, Micrococcaceae, and Fusobacteria. Heart rate and cardiac output value were negatively correlated with the abundance of Bacteroidetes. The mean pulmonary artery pressure value was positively correlated with the abundance of Proteobacteria and Micrococcaceae, and negatively with the abundance of Holdemanella.
本研究旨在评估肝硬化患者肠道菌群失调与血流动力学变化（高动力循环）之间的关系，以及血流动力学变化与该疾病并发症之间的关系。本研究纳入了47例肝硬化患者。采用16S rRNA基因测序评估粪便微生物群。进行超声心动图检查并同时评估血压和心率，以评估全身血流动力学。与血流动力学正常的患者相比，高动力循环患者的肝硬化更严重，白蛋白、钠和凝血酶原水平更低，C反应蛋白、天冬氨酸转氨酶和总胆红素水平更高，门肺高压、腹水、显性肝性脑病、低白蛋白血症、低凝血酶原血症、全身炎症和严重高胆红素血症的发生率更高。与血流动力学正常的患者相比，高动力循环患者的变形菌门、肠杆菌科、芽孢杆菌属、链球菌科、乳杆菌科、梭杆菌属、微球菌科、肠道杆菌属、严格意义上的梭菌属、变形杆菌属和瘤胃球菌属丰度增加，而拟杆菌门、拟杆菌科、霍尔德曼菌属和丁酸弧菌属丰度降低。全身血管阻力和心输出量值与变形菌门、肠杆菌科、芽孢杆菌属、链球菌科、乳杆菌科、微球菌科和梭杆菌属的丰度相关。心率和心输出量值与拟杆菌门的丰度呈负相关。平均肺动脉压值与变形菌门和微球菌科的丰度呈正相关，与霍尔德曼菌属的丰度呈负相关。
