肠道菌群对酒精性肝病患者病情发生发展的影响

The impact of gut microbiota on the development and prognosis of alcoholic liver disease

目的探究肠道菌群对酒精性肝病患者病情发生发展的影响,旨在为临床上治疗酒精性肝病患者提供科学依据。方法选取2017年1月~2018年8月于温州中医院接受治疗的48例酒精性肝病患者为观察组,48例常规体检健康人群为对照组,比较两组肠道菌群的分布、血清炎症因子水平以及肝功能水平。结果观察组患者粪便中的肠球菌、大肠埃希菌、粪肠球菌数量高于对照组;对照组患者粪便中的双歧杆菌数量高于观察组,差异均有统计学意义(t=2.426,P=0.018;t=2.355,P=0.025;t=2.393,P=0.022;t=2.506,P=0.014);观察组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均高于对照组,差异均有统计学意义(t=2.037,P=0.045;t=2.058,P=0.042);观察组丙氨酸氨基转移酶(ALT)、天冬氨酸转氨酶(AST)以及AST/ALT均高于对照组,差异均有统计学意义(t=2.104,P=0.038;t=2.217,P=0.032;t=2.154,P=0.035)。结论酒精性肝病患者存在肠球菌、大肠埃希菌、粪肠球菌生长过快、双歧杆菌生长不足的现象,导致血清炎症水平增加,对肝功能造成不利影响,加重病情的发展,临床上应加以重视。

Objective To discuss the influence of gut microbiota on the development and prognosis of alcoholic liver disease,and to provide scientific evidence for clinical treatment of patients with alcoholic liver disease.Methods 48 patients with alcoholic liver disease treated in our hospital from January 2017 to August 2018 were enrolled in the observation group,meanwhile,48 healthy individuals were recruited as controls.The distribution of intestinal flora,serum inflammatory factor levels and liver function were assessed and compared between the two groups.Results The numbers of Enterococcus,Escherichia coli and Enterococcus faecalis in the feces of the observation group were higher than that of in the control group,while the number of Bifidobacteria was lower,the differences were statistically significant(t=2.426,P=0.018;t=2.355,P=0.025;t=2.393,P=0.022;t=2.506,P=0.014).The serum levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the observation group were higher than those in the control group,the differences were statistically significant(t=2.037,P=0.045;t=2.058,P=0.042).The serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and AST/ALT ratio were higher in the observation group than those in the control group,and the differences were statistically significant(t=2.104,P=0.038;t=2.217,P=0.032;t=2.154,P=0.035).Conclusions The composition of gut flora is altered in patients with alcoholic liver disease with overgrowth of Enterococcus,Escherichia coli,Enterococcus faecalis and insufficient growth of bifidobacteria,resulting in a significant increase in serum inflammation levels,and adversely affecting liver function.