Changes in intestinal microflora in patients with chronic severe hepatitis  

慢性重型肝炎患者肠道菌群变化及其作用的研究(英文)

作　　者：李兰娟[1] 吴仲文[1] 马伟杭[1] 俞云松[1] 陈亚岗[1] 

机构地区：[1]浙江大学医学院附属第一医院传染科,杭州310003

出　　处：《Chinese Medical Journal》2001年第8期86-89,111,共5页中华医学杂志（英文版）

摘　　要：Objective　To investigate changes in intestinal microflora in patients with chronic severe hepatitis (CSH), and their role in this life-threatening disease.Methods　We classified nineteen patients with chronic severe hepatitis as the CSH group, thirty patients with chronic hepatitis (CH) as the CH group and thirty-one healthy volunteer as the control group. Fecal flora from all subjects were analyzed. Concentrations of plasma endotoxin, serum cytokines tumor necrosis factor alpha (TNF-α) and interleukin-1 beta (IL-1β) and liver function were assessed.Results　The number of fecal bifidobacterium (P<0.001, P<0.05 respectively), as well as bacteroidaceae (P<0.001, P<0.01 respectively) were significantly deceased in patients with chronic severe hepatitis compared with the CH and control groups, while the number of enterobacteriaceae (P<0.001, P<0.05 respectively) and yeasts (P<0.01, P<0.05 respectively) were significantly increased. Levels of plasma endotoxin, serum TNF-α, IL-1β and total bilirubin (TBiL) were significantly increased in the CSH group. The concentration of endotoxin positively correlated with levels of both TNF-α, IL-1β and TBiL (P<0.001, respectively). Levels of plasma endotoxin were positively correlated with the number of fecal enterobacteriaceae and negatively correlated with bifidobacterium (P<0.05, P<0.001, respectively).Conclusion　Intestinal flora in patients with chronic severe hepatitis were severely disturbed and gut mircobiological colonization resistance was impaired. Changes in intestinal flora may have a pivotal role in both the elevation of plasma endotoxin and further hepatic lesions resulting in liver failure.目的　研究慢性重型肝炎患者肠道菌群的变化及其在这种重危疾病的发病过程中的作用。方法　用光冈氏法对 19例慢性重型肝炎患者 (CSH组 )、30例慢性肝炎患者 (CH组 )及 31例健康志愿者 (对照组 )的粪便菌群进行定性定量分析 ,同时检测血内毒素、肿瘤坏死因子 (TNF α)、白介素 1(IL 1β)的水平及肝功能的变化。结果　CSH组与对照组和CH组相比较 ,类杆菌、双歧杆菌值显著减少 (类杆菌 :各自P <0 0 0 1、P <0 0 1;双歧杆菌 :各自P <0 0 0 1,P <0 0 5 ) ,而肠杆菌科细菌、酵母菌显著增加 (肠杆菌科细菌 :各自P <0 0 0 1,P <0 0 5 ;酵母菌 :各自P <0 0 1,P <0 0 5 )。CSH组血内毒素、肿瘤坏死因子 (TNF α)、白介素 1(IL 1β)水平及总胆红素浓度与对照组和CH组相比较 ,均有不同程度的显著升高。血内毒素水平与血TNF α、IL 1β水平及总胆红素浓度呈正相关。血内毒素水平与肠杆菌科细菌值呈正相关 (r =0 2 2 8,P <0 0 5 ) ,与双歧杆菌数量呈负相关 (r =- 0 4 13,P<0 0 0 1)。结论　慢性重型肝炎患者肠道菌群严重失调 ,肠道定植抗力严重受损。

关 键 词：chronic severe hepatitis  ·   intestine  ·  micr oflora  ·  endotoxin  ·  cytokines 

分 类 号：R575.1[医药卫生—消化系统]