| Background:Coronary artery atherosclerotic heart disease(CHD)is a kind of disease which refers to vascular stenosis or occlusion caused by atherosclerosis(AS).When the oxygen consumption of myocardium increases,the stenotic or occluded coronary vessels fail to compensate for the increase of oxygen supply,leading to clinical symptoms.Therefore,coronary atherosclerosis is the most direct cause of CHD.The mechanisms that cause AS have been described in a variety of theories,including the lipid infiltration theory,the endothelial injury-response theory,the platelet aggregation and thrombosis hypothesis,and the smooth muscle cloning hypothesis and so on.At present,it is generally believed that its pathological basis is low density lipoprotein(LDL)entering the damaged vascular intima and becoming oxidized LDL(ox LDL)through oxidized lipoprotein.Ox LDL can not be recognized by normal LDL receptors,but easily recognized by scavenger receptors of macrophages,and promotes macrophages to form foam cells,that is,the earliest atherosclerotic lesion lipid streaks.In addition,macrophages secrete a variety of growth factors and proinflammatory mediators,promoting plaque growth and inflammatory response.T lymphocytes entering the intima of blood vessels can recognize antigens presented by macrophages and dendritic cells and activate them to produce a series of strong cytokines that lead to arteriosclerosis.Lipid stripes evolve into fibrolipid lesions and fibrous plaques with the involvement of various mechanisms described above..Therefore,a high level of LDL is a recognized risk factor for AS.At present,although various lipid-lowering drugs have been applied to clinical,some patients' symptoms cannot be effectively controlled.The high morbidity and death rate of coronary heart disease remain an unsolved problem,which brings heavy burden to individuals and countries.Therefore,new targets for CVD prevention and treatment need to be explored.The human gut has a large,complex,dynamically changing microbial community that is mainly composed of bacteria,but also viruses,fungi,protozoa,and archaea.It is estimated that the gut microbiota has more than 1,100 species,which is 150 times genes more than the human host genomes.Intestinal flora can be divided into beneficial bacteria,harmful bacteria and neutral bacteria.Studies have shown that coronary heart disease and chronic heart failure are related to intestinal flora disorders.The purpose of this study is to explore the characteristics of intestinal flora in elderly patients with coronary heart disease and heart failure,and to provide a new target for the prevention and treatment of patients with coronary heart disease and chronic heart failure.Objective:Through the detection of intestinal flora of elderly patients with coronary heart disease,elderly coronary heart disease complicated with heart failure and healthy old people,this study explores the characteristics of intestinal flora in elderly patients with coronary heart disease(CHD),CHD complicated with heart failure(CHF)and elderly healthy people.Besides,it discusses the correlation between CHD and CHF and intestinal flora.Methods:A prospective study was conducted among 40 patients with coronary heart disease,40 patients with coronary heart disease and heart failure and 40 health examinees in the Fifth Affiliated Hospital of Zhengzhou University from January2018 to April 2018.The subjects in the three groups were the elderly(age?60 years)with an average age of 66(+3.0 years).The stool samples of these observers were about 0.5g.Total DNA was extracted from feces.The 16 S r DNA/18 S r DNA/ITS was extracted from 16 S r DNA./ Specific regions such as functional genes were amplified by PCR,then the products were purified,eluted,detected by 2% agarose electrophoresis and quantified.The purified amplified fragments were constructed into PE 2*300 library,sequenced by Miseq PE300 platform of Illumina Company,and the original data were uploaded to NCBI database.After Read splicing,OTU clustering,alpha diversity analysis and species difference analysis,the species information of samples was finally obtained.The experimental results were analyzed on the i-sanger cloud platform.The student's t test and Wilcoxon rank sum test were used.P < 0.05 showed significant differences,P < 0.01 showed extremely significant differences.This study used SPSS21.0 statistical software.Chi-square tested gender among the three groups,one-way analysis of variance was used to analyze age,blood glucose,BMI and other differences among the three groups.Results:The abundance of intestinal flora in elderly patients with CHD and CHF was lower than that in elderly healthy people(P=0.02,P=0.003,P<0.05),but there was no significant difference in the diversity of intestinal flora between elderly patients and healthy people(P=0.10,P=0.57,P>0.05).The abundance of Bacteroides in healthy group was significantly higher than that in coronary heart disease group(P = 0.02,P< 0.05)and coronary heart disease with heart failure group(P = 0.01,P < 0.05).The abundance of Chlamydia in coronary heart disease group and coronary heart disease with heart failure group was significantly higher than that in healthy group(P = 0.02,P = 0.01,P < 0.05).After LEFSe analysis of the sample information,it got the following results: The flora of higher abundance in the healthy group were mainly Bacteroides,Bacteroidia and Bacteroides.The flora of higher abundance in CHD group were Ruminococcaceae,Ruminococcus,Intestinibacter genus,Ruminiclostridium genus,Clostridiaceae and Clostridium.The flora of higher abundance in CHD patients with heart failure were Firmicutes and Enterobacte.Conclusions:The intestinal flora characteristics of elderly patients with coronary heart disease and coronary heart disease complicated with heart failure are different from those of elderly healthy people,and the difference is statistically significant.The intestinal flora may be involved in the occurrence and development of coronary heart disease and heart failure. |
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