急性心肌梗死患者肠道菌群多样性分析与血清短链脂肪酸谱变化的关联性研究

摘要/Abstract

摘要： 目的探讨急性心肌梗死（AMI）患者肠道菌群多样性分析与血清短链脂肪酸谱变化的关联性。方法选取2023年8月至2025年4月于淮安市洪泽区人民医院心内科诊治的35例AMI患者作为研究对象，同期选取35例健康体检者设立为对照组，对比肠道菌群（类杆菌、肠杆菌、肠球菌、梭菌、双歧杆菌、乳酸杆菌）、短链脂肪酸（乙酸、丁酸、丙酸、戊酸、己酸）水平变化;分析肠道菌群与短链脂肪酸的相关性。结果 AMI组的类杆菌、双歧杆菌、乳酸杆菌数量[（4.08±0.79 vs 7.36±1.25）Ig CFU/g、（3.68±0.85 vs 12.41±1.63）Ig CFU/g、（4.75±1.23 vs 14.98±1.96）Ig CFU/g]和乙酸、丁酸、丙酸、戊酸、己酸水平[（4732.74±147.33 vs 5387.96±261.74）µg/mL、（1675.97±182.27 vs 1912.05±217.13）µg/mL、（427.59±98.42 vs 501.96±143.99）µg/mL、（43.69±8.06 vs 56.23±12.36）µg/mL、（407.07±163.97 vs 638.74±175.67）µg/mL]均少于对照组，肠杆菌、肠球菌、梭菌数量[（17.29±2.74 vs 5.29±1.63）Ig CFU/g、（15.79±2.41 vs 4.79±0.98）Ig CFU/g、（8.10±1.63 vs 5.69±1.23）Ig CFU/g]均多于对照组（t=13.160、28.157、26.158、12.905、4.927、2.523、5.027、5.704、22.266、24.991、6.985;P<0.05）。Pearson相关性分析显示，类杆菌、双歧杆菌、乳酸杆菌与乙酸、丁酸、丙酸、戊酸、己酸呈正相关（P<0.05）;肠杆菌、肠球菌、梭菌数量与乙酸、丁酸、丙酸、戊酸、己酸呈负相关（P<0.05）。结论 AMI患者存在肠道菌群失调情况，即有益菌（类杆菌、双歧杆菌、乳酸杆菌）减少和有害菌（肠杆菌、肠球菌、梭菌）增殖，且血清短链脂肪酸（乙酸、丁酸、丙酸、戊酸、己酸）水平会受肠道菌群失调影响。

关键词: 急性心肌梗死, 肠道菌群, 短链脂肪酸

Abstract: Objective To investigate the diversity of gut microbiota and its association with the change in serum short-chain fatty acids in patients with acute myocardial infarction (AMI). Methods A total of 35 patients with AMI who were diagnosed and treated in Department of Cardiology, The People’s Hospital of Hongze District, from August 2023 to April 2025 were enrolled as AMI group, and 35 individuals who underwent physical examination during the same period of time were enrolled as control group. The two groups were compared in terms of the changes in the levels of gut microbiota (Bacteroides, Enterobacter, Enterococcus, Clostridiaceae, Bifidobacterium, and Lactobacillus) and short-chain fatty acids (acetic acid, butyric acid, propionic acid, valeric acid, and caproic acid), and the correlation between gut microbiota and short-chain fatty acids was analyzed. Results Compared with the control group, the AMI group had significantly lower numbers of Bacteroides (4.08±0.79 Ig CFU/g vs 7.36±1.25 Ig CFU/g, t = 13.160, P<0.05), Bifidobacterium (3.68±0.85 Ig CFU/g vs 12.41±1.63 Ig CFU/g, t = 28.157, P<0.05), and Lactobacillus (4.75±1.23 Ig CFU/g vs 14.98±1.96 Ig CFU/g, t = 26.158, P<0.05), significantly lower levels of acetic acid (4732.74±147.33 µg/mL vs 5387.96±261.74 µg/mL, t = 12.905, P<0.05), butyric acid (1675.97±182.27 µg/mL vs 1912.05±217.13 µg/mL, t = 4.927, P<0.05), propionic acid (427.59±98.42 µg/mL vs 501.96±143.99 µg/mL, t = 2.523, P<0.05), valeric acid (43.69±8.06 µg/mL vs 56.23±12.36 µg/mL, t = 5.027, P<0.05), and caproic acid (407.07±163.97 µg/mL vs 638.74±175.67 µg/mL, t = 5.704, P<0.05), and significantly higher numbers of Enterobacter (17.29±2.74 Ig CFU/g vs 5.29±1.63 Ig CFU/g, t = 22.266, P<0.05), Enterococcus (15.79±2.41 Ig CFU/g vs 4.79±0.98 Ig CFU/g, t = 24.991, P<0.05), and Clostridiaceae (8.10±1.63 Ig CFU/g vs 5.69±1.23 Ig CFU/g, t = 6.985, P<0.05). The Pearson correlation analysis showed that Bacteroides, Bifidobacterium, and Lactobacillus were positively correlated with acetic acid, butyric acid, propionic acid, valeric acid, and caproic acid (P <0.05), and Enterobacter, Enterococcus, and Clostridiaceae were negatively correlated with acetic acid, butyric acid, propionic acid, valeric acid, and caproic acid (P<0.05). Conclusion Gut microbiota dysbiosis is observed in patients with AMI, i.e., the reduction in probiotic bacteria (Bacteroides, Bifidobacterium, and Lactobacillus) and the proliferation of harmful bacteria (Enterobacter, Enterococcus, and Clostridiaceae), and the serum levels of short-chain fatty acids (acetic acid, butyric acid, propionic acid, valeric acid, and caproic acid) are affected by gut microbiota dysbiosis.

Key words: Acute myocardial infarction, Gut microbiota, Short-chain fatty acids

孟小攀, 郑平高, 贺小玮, 王军. 急性心肌梗死患者肠道菌群多样性分析与血清短链脂肪酸谱变化的关联性研究[J]. 心血管病防治知识, 2025, 15(21): 27-31.

MENG Xiaopan, ZHENG Pinggao, HE Xiaowei, WANG Jun. Diversity of gut microbiota and its association with the change in serum short-chain fatty acids in patients with acute myocardial infarction[J]. Prevention and Treatment of Cardiovascular Disease, 2025, 15(21): 27-31.

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