【目的】研究脑血管疾病风险人群湿证相关肠道菌群的特征及其影响因素。【方法】基于2021年10月至2023年2月在广东开展的脑血管疾病风险人群湿证相关的流行病学调查，纳入60例研究对象（包括脑血管疾病风险组41例和健康对照组19例），进行湿证诊断与脑卒中风险评级，收集粪便样本，采用高通量16SrRNA测序技术及生物信息学方法分析菌群特征。【结果】（1）共53例诊断为湿证（88.33%），风险组与健康组间及低、中、高危3组间在湿证诊断量化得分的组间比较有统计学差异（P=0.016；P=0.041）。（2）湿证组与非湿证组的肠道菌群物种种类及丰度无显著性差异。（3）在已诊断为湿证的人群中，健康组与风险组的Alpha多样性无显著性差异，而Beta多样性分析有显著性差异；LEfSe分析发现梭杆菌和乳杆菌富集于风险组；相关性分析提示差异菌与糖尿病、血脂异常、肥胖3个危险因素以及颈动脉内-中膜厚度（IMT）相关。（4）在已诊断为湿证且有脑血管疾病危险因素的人群中，低、中、高危3组的Alpha多样性无显著性差异，而Beta多样性分析则提示有显著性差异；LEfSe分析发现，Acidaminococcaceae、Phascolarctobacterium、Butyricimonas明显富集于低危组，Veillonellaceae明显富集于中危组，Ruminococcus 2、Alloprevotella明显富集于高危组；相关性分析提示，差异菌与高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、白细胞计数（WBC）、中性粒细胞计数（NEUT）相关。【结论】以湿证为主的广东地区人群，湿证程度与脑卒中风险有关，且呈现与亚临床动脉粥样硬化、炎性反应、脂质代谢相关的特征菌群。

Objective To investigate the characteristics of gut flora related to dampness syndrome in the population at risk of cerebrovascular disease and to explore their influencing factors. Methods Based on the results of epidemiological investigation of damp syndrome in at-risk population of cerebrovascular disease in Guangdong from October 2021 to February 2023，60 subjects（including 41 at-risk cases of cerebrovascular disease and 19 healthy controls）were included in the study. The identification of dampness syndrome and the risk rating of stroke were carried out for the subjects，and fecal samples were collected. High-throughput 16S rRNA sequencing technology and bioinformatics methods were used to analyze the characteristics of gut flora. Results （1）A total of 53 cases（88.33%）were identified as dampness syndrome. There was significant difference in the quantitative score of dampness syndrome between the risk group and the healthy group，and between the low-，medium- and high-risk groups（P=0.016；P=0.041）.（2）There was no statistical difference in the species and abundance of gut flora between the dampness syndrome group and the non-dampness syndrome group.（3）In the population identified as dampness syndrome，there was no significant difference in Alpha diversity between the healthy group and the risk group，but there was significant difference in Beta diversity analysis；LEfSe analysis found that Fusobacterium and Lactobacillus were enriched in the risk group；correlation analysis showed that the differential bacteria were related to the three risk factors of diabetes，dyslipidemia and obesity and carotid intima-media thickness（IMT）.（4）In the population identified as dampness syndrome and having the risk of cerebrovascular disease，there was no significant difference in Alpha diversity among three groups with different levels of risks，while significant difference in Beta diversity was observed；LEfSe analysis showed that Acidaminococcaceae，Phascolarctobacterium and Butyricimonas were enriched in the low-risk group，Veillonellaceae was enriched in the medium-risk group，and Ruminococcus 2 and Alloprevotella were enriched in the high-risk group；correlation analysis showed that the differential bacteria were associated with high-density lipoprotein cholesterol（HDL-C），low-density lipoprotein cholesterol（LDL-C），white blood cell count（WBC），and neutrophil count（NEUT）.Conclusion In the Guangdong population predominated by dampness syndrome，the severity of dampness syndrome is related to the risk of stroke，and the specific flora associated with sub-clinical atherosclerosis inflammatory response and lipid metabolism are presented.

R277.7

国家重点研发计划重点专项（编号：2018YFC1705002）；广州市科技计划市校（院）联合资助项目（编号：202102010300，2024A03J0741）；广东省中医药局科研项目（编号：20225021）；省部共建中医湿证国家重点实验室专项重点项目（编号：SZ2021ZZ07）；国家中医药管理局第七批全国老中医药专家学术经验继承工作项目 （编号：国中医药办人教函〔2021〕272号）；国家中医药管理局高水平中医药重点学科建设项目 （编号：国中医药人教函〔2023〕85号）；2024年度广州中医药大学高质量提升项目