基于肠道菌群与血清代谢组学的联合分析，探讨草酸钙尿路结石患者的肠道菌群结构特征及其与代谢谱变化之间的关联机制。

选取经影像学确诊的草酸钙尿路结石患者及健康对照者，采集粪便及空腹血清样本。采用16S rRNA高通量测序分析肠道菌群结构，采用UHPLC-MS/MS进行靶向代谢组学检测。多变量统计分析筛选差异菌群及代谢物，Spearman相关性分析构建菌群-代谢物关联网络。

与健康对照组相比，草酸钙结石患者肠道菌群物种丰富度升高，菌群结构明显分离。菌群组成方面，共生菌如双歧杆菌属、布劳特氏菌属及罗斯氏菌属显著减少，而拟杆菌属、普雷沃菌属及阿克曼菌属相对增加。代谢组学结果显示患者血清代谢谱显著改变，主要表现为脂质代谢紊乱、氨基酸代谢异常及氧化应激相关代谢物下降。相关性分析提示肠道菌群与多种代谢物之间存在显著相关性。

草酸钙尿路结石患者存在肠道菌群结构失衡及血清代谢谱紊乱，二者通过多通路相互作用共同参与疾病发生过程。

To investigate the structural characteristics of gut microbiota in patients with calcium oxalate urinary calculi and to explore the correlation mechanisms underlying serum metabolic, based on an integrated analysis of gut microbiomics and serum metabolomics.

Patients with imaging-confirmed calcium oxalate urinary calculi and healthy controls were enrolled. Fecal samples and fasting serum specimens were collected from all participants. 16S rRNA high-throughput sequencing was applied to analyze gut microbiota structure, and UHPLC-MS/MS was used for targeted metabolomics profiling. Multivariate statistical analyses were performed to identify differentially abundant microbial taxa and metabolites. Spearman correlation analysis was adopted to construct the microbiota-metabolite correlation network.

Compared with the healthy control group, patients with calcium oxalate calculi presented increased species richness of gut microbiota and significantly distinct microbial community structure. In terms of microbial composition, symbiotic bacteria including Bifidobacterium, Blautia, and Roseburia were markedly decreased, while the relative abundances of Bacteroides, Prevotella, and Akkermansia were increased. Metabolomic results indicated obvious disturbances in serum metabolic profiles of patients, which were predominantly characterized by lipid metabolism disorders, abnormal amino acid metabolism, and reduced levels of oxidative stress-related metabolites. Correlation analysis revealed significant correlations between specific gut microbial taxa and multiple differentially expressed metabolites.

Patients with calcium oxalate urinary calculi exhibit gut microbiota dysbiosis and disrupted serum metabolic profiles. These two layers of alteration may interact through multiple interconnected pathways and jointly contribute to the pathogenesis of the disease.