慢性乙型肝炎、肝硬化和肝衰竭患者肠道菌群变化研究*

目的 探讨慢性乙型肝炎（CHB）、肝硬化(LC)和肝衰竭(LF)患者肠道菌群的结构差异。方法 纳入CHB患者23例,失代偿期LC患者20例,LF患者6例和成年健康人9例,采用粪便细菌基因组DNA提取试剂盒提取粪便肠道菌群DNA,应用16SrDNA测序技术检测肠道菌群。应用相关生物学软件和统计学软件对测序结果进行分析。结果 肠道菌群门分类水平分析显示,每个样本均以拟杆菌门为主,其次为变形菌门;CHB组拟杆菌门丰度 （617.83）显著高于LC组（343.16）、LF组（182.15）和健康组（236.66）,差异有统计学意义（P<0.05）;LC组变形菌门丰度（183.16）多于CHB组（35.86）、LF组（18.87）和健康组（53.40,P<0.05）;属分类水平显示,CHB组、LC组和LF组均以拟杆菌属为主,其次为普氏菌属、梭菌属;CHB组普氏菌属丰度（345.28）较LC组（46.75）、LF组（5.63）和健康组（20.14）明显增多,LC组拟杆菌属丰度最少（150.28,P<0.05）。结论 CHB、LC和LF患者肠道菌群结构有显著性差异。拟杆菌为肠道优势菌群,在各样本中菌群丰度发生了变化,了解这些变化可能有助于对疾病发生和处理的认识。

Changes of intestinal flora in patients with hepatitis B viral infection

Objective To explore the characteristic of intestinal flora changes in patients with chronic hepatitis B （CHB）,liver cirrhosis （LC） and liver failure （LF）. Methods 23 patients with CHB,20 with LC,6 with LF and 9 healthy persons were recruited in this study. The morning excrements in the 58 cases were collected to test the intestinal flora,and the fecal intestinal flora DNA was obtained by fecal bacterial genome DNA extraction kits. The 16SrDNA of metagenomics sequencing technology was applied to analyze the intestinal flora. The biology and SPSS statistical software were applied to analyze the sequencing results to compare the differences of the intestinal flora in patients with CHB,LC and LF. Results In the phylum level of intestinal flora,all samples showed priority to Bacteroidetes,and secondly was Proteobacteria. Bacteroidetesa bundance in patients with CHB （617.83） was much greater than in with LC （343.16） or with LF （182.15） or in healthy persons （236.66,P<0.05）;Proteobacteria in patients with LC（183.16） was much greater than in with CHB （35.86）,with LF（18.87） or in healthy group（53.40,P<0.05）;in the genus,all samples showed the priority to Bacteroides,and secondly were Prevotella and Fusobacterium. Prevotellaa bundance in patients with CHB （345.28） was much greater than in with LC（46.75）,in with LF（5.63） or in healthy group（20.14）;Bacteroides was the least flora in patients with LC（150.28,P<0.05）. Conclusions Bacteroidetes is the dominant bacteria in all samples and the main difference of flora is the abundance in patients with HBV infection. The Proteobacteria is the most flora in patients with CHB,but is the least in patients with LC and Veillonella increases in patients with LF.