目的 探索结核分枝杆菌感染及常规抗结核化疗过程中肠道菌群的变化差异，为结核病的 临床治疗提供科学依据。方法 提取 89 份粪便样本的基因组 DNA，利用宏基因组测序技术及生物信息学 方法分析结核分枝杆菌感染及常规抗结核化疗过程中肠道微生物菌群的变化。结果 结核分枝杆菌感染 后，结核病患者的肠道菌群结构组成发生显著改变（P = 0.013 4）。随着常规抗结核化疗时间延长，Shannon 指数下降，结核病患者肠道菌群多样性明显降低（P = 0.008 8），结核病患者治愈后菌群结构组成较治疗前出现显著变化（P = 0.002 1）。结核分枝杆菌感染及常规抗结核化疗过程中，拟杆菌属和韦永氏球菌属的 相对丰度逐渐增加。经抗结核化疗后结核病患者肠道内微生物群中部分功能途径发生变化。结论 结核分枝杆菌感染及常规抗结核化疗可以导致肠道菌群紊乱，对肠道菌群的多样性、结构组成和代谢功能 等产生影响。

Objective To explore the changes of intestinal flora during Mycobacterium tuberculosis infec⁃ tion and conventional anti⁃tuberculosis chemotherapy，and to provide scientific basis for clinical treatment of tuber⁃ culosis. Methods Genomic DNA was extracted from 89 stool samples，and the changes of intestinal microflora during mycobacterium tuberculosis infection and conventional anti ⁃ tuberculosis chemotherapy were analyzed by metagenomic sequencing and bioinformatics methods. Results After mycobacterium tuberculosis infection，the composition of intestinal microflora in tuberculosis patients was significantly changed（P = 0.0134）. With the pro⁃ longation of conventional anti⁃tuberculosis chemotherapy，the Shannon index decreased，and the diversity of intesti⁃ nal flora in tuberculosis patients was significantly reduced（P = 0.0088），and the composition of bacterial flora in tuberculosis patients after cure was significantly changed compared with that before treatment（P = 0.0021）. The relative abundances of Bacteroides and Veillonella increased gradually during Mycobacterium tuberculosis infection and routine anti⁃tuberculosis chemotherapy. Some functional pathways in the gut microbiota of tuberculosis patients were changed after anti⁃tuberculosis chemotherapy. Conclusion Mycobacterium tuberculosis infection and conven⁃ tional anti⁃tuberculosis chemotherapy can lead to disturbance of intestinal flora，affecting the diversity，structural composition and metabolic function of intestinal flora.