摘要目的:通过宏基因组分析观察不同炎症类型哮喘患者肠道菌群的特点和差异。方法:选取2021年8月1日至2022年8月31日期间在北京大学第三医院呼吸内科就诊且主要诊断为哮喘的≥18岁成人作为研究对象。最终纳入病情稳定的哮喘患者29例，男13例、女16例，年龄（63±15）岁。留取新鲜粪便标本，提取粪便DNA进行肠道菌群16sRNA高通量测序，比较不同分组哮喘患者肠道菌群的多样性及群落结构，通过物种随机森林和LEfSe分析物种间差异。结果:不同炎症类型哮喘患者存在性别差异，中性粒细胞性哮喘患者中女性患者占比更高（ χ2=4.14， P=0.042）。不同炎症类型哮喘患者肠道菌群Alpha多样性无明显组间差异，但微生物组间存在明显差异，中性粒细胞性哮喘患者芽孢杆菌目（ Bacillales）（ P=0.029）、颤螺菌科（ Oscillospiraceae）（ P=0.015）相对丰度更高，在物种LEfSe分析中，嗜酸粒细胞性哮喘患者真菌（Fungi）相对丰度更高。 结论:不同炎症类型哮喘患者肠道菌群微生物存在组间差异，真菌是区分嗜酸粒细胞性哮喘和中性粒细胞性哮喘患者肠道菌群差异的生物标志物。

abstractsObjective:To observe the characteristics and differences of gut microbiota in asthma patients with different inflammatory types through metagenomic analysis.Methods:Adults aged ≥18 years who visited the Respiratory Clinic of Peking University Third Hospital from August 1, 2021 to August 31, 2022 and were primarily diagnosed with asthma were selected as the study subjects. Finally, 29 patients with stable asthma were included. Fresh fecal samples were collected and the fecal DNA was extracted for high-throughput 16sRNA sequencing of gut microbiota. The diversity and community structure of gut microbiota in different groups of asthma patients were compared, and the species differences were analyzed through random forest and LEfSe analysis.Results:There were sex-based differences in asthma patients with different types of inflammation, and the proportion of female patients was higher in neutrophilic asthma patients ( χ2=4.14, P=0.042). There was no significant intergroup difference in the alpha diversity of gut microbiota among asthma patients with different inflammatory types, but there were significant differences in the microbiome. Patients with neutrophilic asthma had higher relative abundance of Bacillales ( P=0.029) and Oscillospiraceae ( P=0.015). In species LEfSe analysis, patients with eosinophilic asthma had a higher relative abundance of fungi. Conclusion:There are intergroup differences in the gut microbiota of asthma patients with different inflammation types, and fungi are biomarkers that distinguish the differences in gut microbiota between patients with eosinophilic asthma and neutrophilic asthma.