| Objective: To verify the changes in the number and structure of intestinal flora in patients with coronary heart disease,and to determine the levels of serum inflammatory factors such as IL-6,MCP-1,and TNF.Through the discussion of the relationship between intestinal flora,inflammatory factors and CHD,so as to provide new ideas for the development mechanism of CHD and the intervention,diagnosis and treatment of CHD.Methods: According to the diagnostic criteria of "coronary atherosclerotic heart disease" in the《Journal of Internal Medicine(8th Edition)》,patients with CHD diagnosed by coronary angiography(CAG)in the Affiliated Hospital of Qingdao University from January 2020 to April 2021 were selected as the research subjects.According to SYNTAX score,CHD patients were risk stratified: non-high-risk CHD group(<33 points,20 cases),high-risk CHD group(≥ 33 points,20 cases),during the same period,20 healthy subjects were selected as the control group.Fasting blood samples and stool samples were taken in the morning.The levels of inflammatory cytokines IL-6,MCP-1 and TNF in serum of subjects were determined by enzyme-linked immunosorbent assay(ELISA).Using 16 S r RNA sequencing technology,the species classification,Alpha diversity analysis,Beta diversity analysis and significance analysis between groups of intestinal microflora of patients with coronary heart disease and healthy people were analyzed.SPSS.25 Graph Pad Prism8.0 and Microsoft Excel-2007 were used TTest test and correlation analysis on the data.Results:1.The clinical baseline data of patients in the three groups,such as age,gender,smoking history,family history,history of hypertension,history of diabetes,blood lipid,uric acid,etc,were not statistically significant.Compared with the control group,the ratio of platelet count to lymphocyte count(PLR)and neutrophils count to lymphocyte count(NLR)were increased in patients with coronary heart disease,and the above changes were more obvious in the high-risk group,with statistical significance(P<0.05).2.Compared with the control group,serum proinflammatory factors IL-6,TNF-αand MCP-1 were increased in patients with CHD,and the above changes were more obvious in high-risk group,with statistical significance(P<0.05).3.Compared with the control group,there were statistical differences in the number of classified operating units(OTU),richness and diversity of intestinal microflora in patients with coronary heart disease,the number of OTU and species richness and diversity of intestinal microflora in patients with coronary heart disease decreased.4.The dominant flora composed of human microorganism mainly included Bacteroides,Firmicutes,Proteobacteria,Actinobacillus,etc.and no statistical significance was found between groups(P>0.05).At the level of intestinal flora species,Bacillus pallidus,Arthrobacter,Acidobacter,Schaedleri,Macginleyi,Actinomycetes,Rhizobium,Neisseria,Intercystis and Deferrobacter in patients with CHD were lower than those in the control group.The species richness of Bacillus,Clostridium coccidioides,Pickettii,Caecimuris and Bacillus acid-producing were higher than those in the control group.5.According to the prediction of COG,bacteria in patients with CHD are mainly associated with the following biological processes: DNA replication,repair and recombination,ribosome processing and modification,post-transcriptional modification,protein conversion,molecular chaperone,lipid transport and metabolism,cell membrane/wall origin,extracellular matrix,etc.6.According to the prediction of KEGG,the bacteria represented in patients with CHD are mainly related to the following biological processes: amino acid and nucleotide metabolism,biosynthesis and metabolism,cell growth and apoptosis,immunity,infection,tumor,DNA replication,etc.7.The levels of serum IL-6,TNF-α and MCP-1 increased with the decrease of OTU,and there was a negative correlation between OTU and the levels of serum IL-6,TNF-α and MCP-1(r<0,P<0.01).Conclusion:1.The incidence of CHD was correlated with the number of intestinal flora OTU,richness,diversity and community structure,suggesting that intestinal flora may be involved in the occurrence and development of CHD.2.Serum levels of IL-6,TNF-α and MCP-1 in CHD patients were higher than those in healthy patients,and serum levels of IL-6,TNF-α and MCP-1 were higher in the high-risk SYNTAX score group.It suggests that gut flora in patients with coronary heart disease may participate in the pathogenesis of coronary heart disease by affecting inflammatory factors in patients.3.The changes in the proportion of intestinal flora and the differences in the levels of serum inflammatory factors in patients with CHD may provide new theories and research ideas for the study of the pathogenesis,diagnosis and treatment of CHD. |
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