肠道菌群在抑郁合并心力衰竭患者分布特征

Distribution Characteristics of Intestinal Microbiota in Patients with Depression and Heart Failure

摘要: 目的：研究抑郁状态下不同心力衰竭程度患者肠道菌群分布特征，探究其差异及寻找潜在菌群及治疗方案。方法：随机选取2023年1月至2025年1月巴彦淖尔市医院收治的心力衰竭患者，依据病人健康9项筛查(patienthealthquestionnaire-9, PHQ-9)对HF患者进行抑郁症状评估，选取心衰合并抑郁状态的患者60例，按照射血分数 < 35% (Q组25例)，≥35% (W组35例)；统计分析两组肠道菌群分布状态。结果：按照GEN分类排名前10位的分别是：Enterococcus、Escherichia-Shigella、Bacteroides、Streptococcus、Ligilactobacillus、Agathobacter、Bifidobacterium、Akkermansia、Faecalibacterium、Blautia；火山图中提示下调代谢物：Faecalibacterium；上调代谢物：Eggerthella、Dielma、UBA1819。结论：本研究发现抑郁合并不同程度心力衰竭的肠道菌群有异质性，Faecalibacterium、Eggerthella改变与短链脂肪酸、胆汁酸代谢相关，心衰病人早期给予肠道菌群调节，延缓疾病进程。

Abstract: Objective: Study the distribution characteristics of gut microbiota in patients with different degrees of heart failure under depression, explore their differences, and search for potential microbiota and treatment plans. Method: Patients with HF admitted to Bayannur Hospital from January 2023 to January 2025 were randomly selected, and their depressive symptoms were assessed using the 9-item Patient Health Questionnaire (PHQ-9). A total of 60 patients with HF and depression were included and divided into two groups based on ejection fraction (EF): Group Q (EF < 35%, 25 cases) and Group W (EF ≥ 35%, 35 cases). The distribution of gut microbiota was statistically analyzed between these two groups. Result: The top 10 rankings according to GEN classification are: Enterococcus, Escherichia-Shigella, Bacteroides, Streptococcus, Ligilactobacillus, Agathobacter, Bifidobacterium, Akkermansia, Faecalibacterium, and Blautia. The volcano plot indicated that Faecalibacterium was downregulated, while Eggerthella, Dielma, and UBA1819 were upregulated. Conclusion: This study found heterogeneity in the gut microbiota of patients with depression and varying degrees of heart failure. The changes in Faecalibacterium and Eggerthella were associated with short-chain fatty acid and bile acid metabolism, suggesting that early modulation of gut microbiota in patients with HF may help delay disease progression.