乙型肝炎肝硬化患者小肠细菌过度生长与疾病严重程度的相关性

魏新朋; 高晓; 马英杰

doi:10.3969/j.issn.1001-5256.2016.04.021

乙型肝炎肝硬化患者小肠细菌过度生长与疾病严重程度的相关性

DOI: 10.3969/j.issn.1001-5256.2016.04.021

新乡医学院附属郑州人民医院消化科,郑州消化疾病研究所

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中图分类号: R512.62;R575.2
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出版历程
- 出版日期: 2016-04-20

Relationship between small intestinal bacterial overgrowth and severity of with hepatitis B cirrhosis

Department of Gastroenterology, Zhengzhou People′s Hospital, Xinxiang Medical University

摘要

摘要:
目的探讨小肠细菌过度生长（SIBO）与乙型肝炎肝硬化病情严重程度的关系。方法选取2014年6月-2015年6月于郑州人民医院消化科就诊的乙型肝炎肝硬化患者47例作为肝硬化组,依Child-Pugh分级分为A级组11例、B级组16例、C级组20例,选取15例健康志愿者作为对照组。测定降钙素原、胆红素、血浆白蛋白、球蛋白水平,通过乳果糖氢呼气试验（LHBT）评估小肠内细菌生长程度。计数资料组间比较采用χ2检验或Fisher确切概率法,计量资料组间比较采用成组t检验,相关分析采用Pearson相关分析法。结果肝硬化组SIBO患病率46.8%（22/47）,Child-Pugh A级组、B级组、C级组的SIBO患病率分别为18.1%（2/11）、43.7%（7/16）、65.0%（13/20）。肝硬化组、B级组和C级组SIBO患病率分别与对照组比较,差异均有统计学意义（P值分别为0.005、0.037、0.001）;代偿期肝硬化（A级组）和失代偿期肝硬化（B、C级）比较,差异有统计学意义（χ2=4.727,P=0.030）。降钙...
- 肝硬化 /
- 肝炎,乙型 /
- 肠杆菌科
Abstract:
Objective To investigate the relationship between small intestinal bacterial overgrowth( SIBO) and the severity of hepatitis B cirrhosis. Methods Forty- seven patients with hepatitis B cirrhosis who visited Department of Gastroenterology,Zhengzhou People's Hospital,from June 2014 to June 2015 were selected as cirrhosis group; these patients consisted of 11 Child- Pugh class A cases,16 Child-Pugh class B cases,and 20 Child- Pugh class C cases. Fifteen healthy volunteers were selected as control group. The levels of procalcitonin,bilirubin,plasma albumin,and globulin were measured in all subjects. The lactulose hydrogen breath test( LHBT) was performed to measure small intestinal bacterial growth. Comparison of categorical data was made by chi- square test or Fisher's exact test. Comparison of normally distributed continuacs data between groups was performed by t test,The correlations of SIBO with procalcitonin,bilirubin,plasma albumin,and albumin / globulin ratio were investigated by Pearson correlation analysis. Results SIBO was found in 22( 46. 8%) of the 47 patients with liver cirrhosis,consisting of 2( 18. 1%) in the 11 Child- Pugh class A cases,7( 43. 7%) in the 16 Child- Pugh class B cases,and 13( 65. 0%) in the 20 Child- Pugh class C cases. The prevalence of SIBO showed a significant difference between the controls and all patients with hepatitis B cirrhosis,Child- Pugh class B cases,or Child- Pugh class C cases( P = 0. 005,0. 037,or 0. 001),but no significant difference between the controls and Child- Pugh class A cases( P = 0. 556); there was a significant difference in the prevalence of SIBO between Child- Pugh class A cases and Child- Pugh class B / C cases( χ~2= 4. 727,P = 0. 030). The levels of procalcitonin,bilirubin,plasma albumin,and globulin were significantly correlated with LHBT set- value( r = 0. 895,0. 907,- 0. 810,and 0. 755,respectively,all P < 0. 001). Conclusion The prevalence of SIBO increases with exacerbation of liver injury in patients with hepatitis B cirrhosis. The levels of procalcitonin,bilirubin,and globulin are positively correlated with SIBO,while plasma albumin level is negatively correlated with SIBO.
- liver cirrhosis /
- hepatitis B /
- enterobacteriaceae

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