目的：探究原发性翼状胬肉患者进展期与静止期眼表菌群的组成与结构差异，并筛选与翼状胬肉进展相关的关键菌群生物标志物。

方法：采用横断面研究设计，纳入进展期翼状胬肉患者(PPG组)、静止期翼状胬肉患者(SPG组)及年龄、性别匹配的健康志愿者(HCG组)。采集所有参与者患眼(或健康眼)结膜拭子，行16S rRNA基因V3-V4区扩增子测序。分析流程包括稀释曲线分析、Alpha/Beta多样性分析、ASV分析，并采用LEfSe分析和Kruskal-Wallis H检验筛选差异菌群。

结果：最终纳入PPG组28例28眼，男11例，女17例，平均年龄60.54±8.44岁； SPG组28例28眼，男10例，女18例，平均年龄61.82±10.21岁； HCG组28例28眼，男12例，女16例，平均年龄64.07±7.27岁，三组一般资料具有可比性(均P>0.05)。有效序列数及稀释曲线证实测序深度充分。三组眼表菌群的Alpha多样性及Beta多样性均无差异(均P>0.05)，提示菌群整体结构相对稳定。LEfSe分析(LDA>3.0)发现，丙酸杆菌目、丙酸杆菌科、皮肤杆菌属及丛毛单胞菌科在PPG组显著富集。经Kruskal-Wallis H检验、Bonferroni法校正P值后确认，PPG组的丙酸杆菌目、丙酸杆菌科和皮肤杆菌属丰度显著高于HCG组(均P<0.05)，但与SPG组无差异(均P>0.05)； 丛毛单胞菌科在SPG组的丰度高于HCG组(P<0.05)，与PPG组及HCG组间均未见显著差异(均P>0.05)。

结论：以皮肤杆菌属为代表的丙酸杆菌类群在进展期翼状胬肉患眼呈现出富集趋势，该菌属与翼状胬肉的进展之间存在潜在关联。

METHODS: A cross-sectional study design was adopted. Patients with progressive pterygium(PPG group), stationary pterygium(SPG group), and age- and sex-matched healthy volunteers(HCG group)were enrolled. Conjunctival swabs were collected from the affected eye(or the healthy eye in controls)of each participant. 16S rRNA gene amplicon sequencing of the V3V4 region was performed. The analytical workflow encompassed rarefaction curve analysis, Alpha/Beta diversity analyses, ASV analysis. LEfSe analysis and the Kruskal-Wallis H test were used to screen differential microbiota.

RESULTS: Final enrollment included 28 patients(28 eyes)in each group: PPG(11 males, 17 females; mean age 60.54±8.44 y), SPG(10 males, 18 females; mean age 61.82±10.21 y), and HCG(12 males, 16 females; mean age 64.07±7.27 y). No significant differences were found among the three groups in baseline characteristics(all P>0.05). The number of valid sequences and the rarefaction curves confirmed sufficient sequencing depth. Alpha/Beta diversity analyses showed no statistically significant differences among the three groups(all P>0.05), indicating that the overall structure of the ocular surface microbiota was relatively stable. LEfSe analysis(LDA score>3.0)revealed that the Propionibacteriales, the Propionibacteriaceae, the Cutibacterium and the Comamonadaceae were significantly enriched in the PPG group. Following Kruskal-Wallis H tests with Bonferroni correction for multiple comparisons, the relative abundances of Propionibacteriales, Propionibacteriaceae, and Cutibacterium were significantly higher in PPG group than in the HCG group(all PSymbol|@@0.05), but did not differ significantly between the PPG and SPG groups(all P>0.05). The abundance of Comamonadaceae was significantly higher in SPG group than in HCG group(PSymbol|@@0.05), whereas PPG group not differ from either group(all P>0.05).

CONCLUSION: Cutibacterium, the representative genus of the propionibacterial group, tends to be enriched in eyes with progressive pterygium, indicating a potential association between this genus and pterygium progression.