肝硬化患者肠道菌群的研究

目的:研究肝硬化患者肠道菌群的变化、并分析血内毒素水平与肠道细菌的关系。方法:对37例肝硬化患者和18例健康者粪便中8种常见的厌氧菌及需氧菌进行定量研究,以偶氮基质显色法测外周血内毒素。结果:(1)肝硬化患者双歧杆菌、拟杆菌、真杆菌量明显低于正常组,而大肠杆菌、产气荚膜梭菌量高于正常组(P<0.05);(2)肝硬化患者肠菌失调程度与肝功能Child-Pugh分级有关;(3)肝硬化患者血内毒素水平与大肠杆菌量存在相关性。结论:肝硬化患者存在肠道菌群失调,具有代表性的厌氧菌减少,需氧菌增多。需氧革兰阴性杆菌大量繁殖可能是引起肝硬化肠源性内毒素血症的一个重要因素。

The Study of Intestinal Flora in Patients with Cirrhosis

Aims: To investigate the changes of intestinal flora and relationship between intestinal flora and plasma endotoxin levels in cirrhotic patients. Methods: Feces from 18 healthy adults and 37 patients with cirrhosis were cultured aerobically and anaerobically. Plasma endotoxin concentrations were determined with a limulus asssay. Results: The number of bifidobacterium. eubacterium. bacteroides decreased significantly (P< 0.05) in patients with cirrhosis than in healthy controls, but Escherichia coli and Clostrirlium perfringens increased markedly. The degreement of changes in intestinal flora was related to the severity of liver dysfunction. A significant correlation was observed between plasma endotoxin levels and the number of E. coli in cirrhotic patients. Conclusions: In cirrhotic patients, anaerobic bacteria decreased and aerobic bacteria increased. The overgrowth of aerobic gram-negative bacteria may play an important role in the development of endotoxemia in cirrhosis.