【摘要】 目的 分析单纯重度三尖瓣关闭不全患者肠道菌群的变化，探索在三尖瓣关闭不全患者进行菌群干预治疗的可行性。方法 以2022年9月—2023年10月连续入住广东省人民医院心外科的单纯重度三尖瓣关闭不全患者为三尖瓣关闭不全试验组(T组，n=20);每纳入1例试验组患者时，同期在住院拟行手术治疗的单纯重度二尖瓣关闭不全患者中随机抽取1例纳入二尖瓣关闭不全对照组(M组，n=20);另外，每纳入2例试验组患者时，在正常人群中选取1例健康成年人纳入健康对照组(N组，n=10)。使用无菌器皿采集T、M、N组三组人群的粪便样本，进行16sRNA测序，根据测序结果进行生物学分析。结果 α多样性显示，T组患者肠道菌群Simpson、Sobs、Chao1、ACE指数低于M组和N组，但无统计学差异(P>0.05)。β多样性显示，T、M和N组三组之间呈彼此分离的情况。菌群与右心功能指标的相关性分析显示，瘤胃球菌科、颤螺菌目、Ruminococcus＿sp＿N15MGS-57、食葡糖罗斯拜瑞氏菌的相对丰度与三尖瓣环收缩期位移呈正相关。结论 重度三尖瓣关闭不全患者存在肠道菌群紊乱，并且多种菌群与重度三尖瓣关闭不全患者的右心功能存在明显的相关性，提示肠道菌群与重度三尖瓣关闭不全的发生发展有一定的相关性。更多还原

【Abstract】 Objective To analyze the changes of intestinal flora in patients with isolated severe tricuspid regurgitation, and explore the feasibility of microbiota intervention therapy in these patients.Methods Patients with isolated severe tricuspid regurgitation who were continuously admitted to the Department of Cardiac Surgery of Guangdong Provincial People’s Hospital from September 2022 to October 2023 were enrolled in the tricuspid regurgitation experimental group(group T,n=20).For each patient in the group T,a patient with isolated severe mitral regurgitation who was hospitalized for surgery was randomly selected during the same period as the group for mitral regurgitation(group M,n=20).In addition, for every two patients enrolled in the experimental group, a healthy adult was selected as the healthy control group(group N,n=10).Stool samples from three groups were collected and then subjected to 16sRNA gene sequencing.Bioinformatics analyses were performed according to the sequencing results.Results Analysis of α diversity showed that the index of Simpson, Sobs, Chao1,ACE of intestinal flora in T group lower than those in M group and N group, but there was no statistically significant difference(P>0.05).The β diversity showed that the three groups were separated from each other.Correlation analysis showed that the relative abundance of Ruminococcaceae, Oscillospirales, Ruminococcus＿sp＿N15MGS-57,and Roseburia＿inulinivorans were positively correlated with tricuspid annular plane systolic excursion.Conclusion The intestinal flora is disturbed in patients with severe tricuspid regurgitation, and there is a significant correlation between multiple microbiotas and right heart function indexes in these patients, suggesting that intestinal flora may be associated with the occurrence and development of severe tricuspid regurgitation.更多还原