乙型肝炎肝硬化患者肠道菌群变化研究*

目的 分析乙型肝炎肝硬化患者肠道菌群的分布情况及其临床意义。方法 2018年 7月～2019年4月我院收治的乙型肝炎肝硬化患者103例(代偿期肝硬化41例和失代偿期肝硬化62例)和同期健康人群20例,采集粪便,采用Illumina Miseq测序法分析肠道菌群结构差异和物种多样性。结果 在健康人,巨单胞菌属、拟杆菌属和粪杆菌属分别为14.8%、11.4%和9.8%,在代偿期肝硬化组,拟杆菌属、粪杆菌属和巨单胞菌属比例分别为15.2%、11.5%和11.2%,在失代偿期肝硬化组,拟杆菌属、粪杆菌属和韦荣球菌属比例分别为16.9%、9.6%和9.2%;健康人Chao指数为(1250.5±283.7),显著高于代偿期肝硬化组【(1111.5±277.1),P＜0.05】或失代偿期肝硬化组【(910.2±369.6),P＜0.05】,健康人Shannon指数为(3.7±0.6),显著高于代偿期肝硬化组【(3.5±0.1),P＜0.05】或失代偿期肝硬化组【(3.3±0.4),P＜0.05】,健康人Simpson指数为(0.3±0.1),显著高于代偿期肝硬化组【(0.2±0.1),P＜0.05】或失代偿期肝硬化组【(0.1±0.4),P＜0.05】。结论 乙型肝炎肝硬化患者肠道菌群丰度和多样性降低,失代偿期肝硬化患者肠道菌群变化更为明显,即存在随着病情进展肠道菌群多样性减少现象,其临床意义值得探讨。

Changes of intestinal flora in patients with hepatitis B liver cirrhosis

Objective The aim of this study was to analyze the distribution of intestinal flora in patients with hepatitis B liver cirrhosis.Methods A total of 103 patients with hepatitis B liver cirrhosis(compensated cirrhosis in 41 and decompensated cirrhosis in 62)and 20 healthy personswere enrolled in our hospital between July 2018 and April 2019,and the sequences of intestinal bacteria were carried out by Illumina Miseq.Results At the genius level,the proportion of Megamonas,Bacteroides and Faecalibacterium in the healthy persons were 14.8%,11.4%and 9.8%,the proportion of Bacteroides,Faecalibacterium and Megamonas in patients with compensated cirrhosis were 15.2%,11.5%and 11.2%,while the proportion of Bacteroides,Faecalibacterium and Veillonella in patients with decompensated liver cirrhosis were 16.9%,9.6%and 9.2%,respectively;we used Chao,Shannon and Simpson index to analyze the flora abundance and diversity,and the Chao index in healthy persons was(1250.5±283.7),significantly higher than(1111.5±277.1,P<0.05)in patients with compensated or(910.2±369.6,P<0.05)in decompensated liver cirrhosis,the Shannon index in healthy persons was(3.7±0.6),significantly higher than(3.5±0.1,P<0.05)in patients with compensated or(3.3±0.4,P<0.05)in decompensated liver cirrhosis,and the Simpson index in the healthy persons was(0.3±0.1),significantly higher than(0.2±0.1,P<0.05)in patients with compensated or(0.1±0.4,P<0.05)in patients with decompensated liver cirrhosis.Conclusion The intestinal flora abundance and diversity in patients with hepatitis B liver cirrhosis decrease as the progress of the disease,which might have a significant implications in dealing with the patients in clinical practice.