背景:肠-肺轴,对呼吸健康至关重要,在肺部和重症监护医学(PCCM)住院患者中没有充分探索。
方法:检查来自三家医科大学附属医院的PCCM住院患者,我们对粪便样本进行了16S核糖体RNA测序(住院患者,n=374;健康对照,n=105)。我们进行了统计分析,以检查PCCM住院患者的肠道菌群组成,将其与健康对照进行比较。此外,我们探索了肠道菌群组成与各种临床因素之间的关联,包括年龄,白细胞计数,中性粒细胞计数,血小板计数,白蛋白水平,血红蛋白水平,住院时间,和医疗费用。
结果:PCCM住院患者的肠道菌群多样性低于健康对照组。主坐标分析显示出明显的总体微生物群结构差异。四种肠型,包括住院患者独有的肠球菌科肠型,已确定。尽管在门一级没有发现任何区别,15个细菌家族表现出不同的丰度。具体来说,PCCM的住院人群显示出肠球菌科的丰度明显更高,乳酸杆菌科,丹毒科,梭菌科,和制革菌。使用随机森林分析,我们计算的受试者工作特征曲线下面积(AUC)为0.75(95%CI=0.69-0.80),用于区分健康个体和住院患者.分类器中保留的四个最丰富的属是Blautia,下颗粒,肠球菌,还有克雷伯菌.
结论:PCCM住院患者肠道菌群失调的证据强调了肠-肺轴的意义,在呼吸健康研究中有希望的进一步途径。
BACKGROUND: The gut-lung axis, pivotal for respiratory health, is inadequately explored in pulmonary and critical care medicine (PCCM) inpatients.
METHODS: Examining PCCM inpatients from three medical university-affiliated hospitals, we conducted 16S ribosomal RNA sequencing on stool samples (inpatients, n = 374; healthy controls, n = 105). We conducted statistical analyses to examine the gut microbiota composition in PCCM inpatients, comparing it to that of healthy controls. Additionally, we explored the associations between gut microbiota composition and various clinical factors, including age, white blood cell count, neutrophil count, platelet count, albumin level, hemoglobin level, length of hospital stay, and medical costs.
RESULTS: PCCM inpatients exhibited lower gut microbiota diversity than healthy controls. Principal Coordinates Analysis revealed marked overall microbiota structure differences. Four enterotypes, including the exclusive Enterococcaceae enterotype in inpatients, were identified. Although no distinctions were found at the phylum level, 15 bacterial families exhibited varying abundances. Specifically, the inpatient population from PCCM showed a significantly higher abundance of Enterococcaceae, Lactobacillaceae, Erysipelatoclostridiaceae, Clostridiaceae, and Tannerellaceae. Using random forest analyses, we calculated the areas under the receiver operating characteristic curves (AUCs) to be 0.75 (95% CIs 0.69-0.80) for distinguishing healthy individuals from inpatients. The four most abundant genera retained in the classifier were Blautia, Subdoligranulum, Enterococcus, and Klebsiella.
CONCLUSIONS: Evidence of gut microbiota dysbiosis in PCCM inpatients underscores the gut-lung axis\'s significance, promising further avenues in respiratory health research.