肝硬化患者肝功能分级与其肠道微生态的相关性研究

肝硬化患者肝功能分级与其肠道微生态的相关性研究
陈瑶;向正国;李科军;陈旭峰
【期刊名称】《广西医科大学学报》
【年(卷),期】2017(34)7
【摘要】目的:观察肝硬化患者肠道菌群分布及肠道通透性的变化,并探讨其与肝功能分级程度的相关性.方法:选择2015年3月至201 6年12月在中国人民解放军第101医院消化内科住院治疗的肝硬化患者93例,按肝功能Child-Pugh分级标准分为A级(31例)、B级(38例)、C级(24例)3组;另选健康体检者40例作为对照组.比较各组肠道菌群分布、血清内毒素水平、血清D-乳酸水平、尿乳果糖/甘露醇(L/M)比值的差异;分析血清内毒素、D-乳酸水平及尿L/M比值与Child-Pugh分级的相关性.结果:与对照组比较,肝硬化患者肠杆菌和肠球菌明显增多(P＜0.05),双歧杆菌明显减少(P＜0.05);与A级组比,B级、C级组的肠杆菌和肠球菌明显增多(P＜0.05),而双歧杆菌明显减少(P＜0.05),C级组以上肠道菌群变化较B级组更显著(P＜0.05).肝硬化患者组血清内毒素、D-乳酸水平及尿L/M比值均较对照组显著升高(均P＜0.05);其中B级组、C级组的血清内毒素、D-乳酸水平及尿L/M比值明显高于A级组(P＜0.05),且C级组增高程度较B级组更显著(P＜
0.05).Spearman相关分析提示,血清内毒素、D-乳酸水平及尿L/M比值均与Child-Pugh分级呈正相关关系(r=0.802、0.731、0.796,均P＜0.05).结论:肝硬化患者存在不同程度的肠道菌群紊乱和肠黏膜通透性增加,该变化随肝功能Child-Pugh分级程度的增加而愈加显著.%Objective:To explore the correlation between liver function and intestinal flora distribution and intestinal mucosal permeability in patients with liver cirrhosis.Methods:93 patients
with liver cirrhosis treated in our hospital from March 2015 to December 2016 were selected and divided into group A (n=31),group B (n=38) and group C (n=24),according to the Child-Pugh classification criteria.40 healthy patients were selected as a control group.The distribution of intestinal flora,the levels of endotoxin and D-lactic acid in serum and the ratio of urinary lactulose/mannitol (L/M) were detected and compared among groups.The correlation between endotoxin level,D-lactate level,the ratio of urinary L/M and Child-Pugh classification were
analyzed.Results:Patients with liver cirrhosis had larger number of enterobacter and enterococcus,but less Bacillus bifidus than the controls (P ＜0.05),and these changes were the most obvious in group C.Spearman correlation analysis revealed that the Child-Pugh classification was positively related to the endotoxin level,D-lactate level and urinary L/M ratio (r=0.802,0.731,0.796;P＜0.05).Conclusion:Liver cirrhosis patients exhibited different degree of intestinal flora disorder and increase in in testinal mucosal permeability,and these changes were more significant with the increase of the grade of Child-Pugh.
【总页数】4页(P1006-1009)
【作者】陈瑶;向正国;李科军;陈旭峰
【作者单位】中国人民解放军第101医院消化内科,无锡 214000;中国人民解放军第101医院消化内科,无锡 214000;中国人民解放军第101医院消化内科,无锡214000;中国人民解放军第101医院消化内科,无锡 214000
【正文语种】中文
【中图分类】R575.2
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