Analysis of the relationship between changes in gut microbiota and prognosis in patients with hypertensive intracerebral hemorrhage

AN Chun-ni; ZHANG Wei-na; AI Mei-mei

doi:10.16048/j.issn.2095-5561.2024.02.10

Abstract：Objective Analyze the changes in gut microbiota in patients with hypertensive intracerebral hemorrhage and their relation-ship with prognosis. Methods A total of 156 patients with hypertensive cerebral hemorrhage treated in the emergency department of the First Affiliated Hospital of Air Force Military Medical University from May 2022 to May 2023 were selected as the study subjects and included as the observation group. In the same period,100 healthy subjects were included as healthy group. The levels of gut mi-crobiota[Escherichia coli,Klebsiella pneumoniae,Lactobacillus,Bifidobacterium,and Escherichia coli ratio (B/E)]were compared between the two groups. At 90 days after the surgery,156 patients with hypertensive intracerebral hemorrhage were divided into a good outcome group (n=103) and a poor outcome group (n=53) based on the modified Rankin scale＜3 points. Logistic regression analysis was used to identify risk factors affecting hypertensive intracerebral hemorrhage patients;The predictive value of receiver operating characteristic (ROC) curve analysis of gut microbiota levels on prognosis. Results The levels of E. coli and Klebsiella pneumoniae in observation group were higher than those in healthy group,while bifidobacterium,Lactobacillus and B/E values in observation group were lower than those in healthy group,with statistical significance (P＜0.05). Age≥60 years and blood loss≥50 ml were independent risk factors for prognosis,and preoperative GCS score,lactobacillus level and B/E value were protective factors for prog-nosis (P＜0.05). The area under the curve of Lactobacillus,B/E and their combination in predicting poor prognosis of hypertensive intracerebral hemorrhage were 0.804,0.730 and 0.968,respectively. Conclusion Patients with hypertensive intracerebral hemorrhage have problems such as intestinal flora disturbance,and the increase of lactobacillus level and B/E value is closely related to the prog-nosis of patients,and the combination of the two indicators has a high predictive value for the prognosis of patients with hypertensive intracerebral hemorrhage.