乙肝肝硬化患者肠道菌群与肝功能及血清炎症因子水平的关系

Relationship between intestinal flora and liver function and serum inflammatory factors in patients with hepatitis b cirrhosis

目的研究乙肝肝硬化患者肠道菌群与肝功能及血清炎症因子水平的关系。方法选取2016年4月至2019年4月来我院确诊并接受治疗的65例乙肝肝硬化患者纳入研究对象,设为观察组;另外选取我院同期门诊健康的65名志愿者纳入研究对象,设为对照组。比较两组谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-8(IL-8)、肠杆菌、肠球菌、双歧杆菌、乳杆菌水平间的差异,对比不同肝功能分级患者肝功能、炎症因子及肠道菌群指标差异,最后以Spearman系数分析肠道菌群指标与乙肝肝硬化患者肝功能及血清炎症因子水平的相关性。结果观察组ALT、AST、ALP、TNF-α、IL-6、IL-8、肠杆菌、肠球菌水平显著高于对照组,差异有统计学意义(P<0.05);观察组双歧杆菌、乳杆菌水平显著低于对照组,差异有统计学意义(P<0.05)。不同肝功能分级患者ALT、AST、ALP、TNF-α、IL-6、IL-8、肠杆菌、肠球菌水平对比A级B级>C级,差异有统计学意义(P<0.05)。经相关性分析,肠杆菌、肠球菌与ALT、AST、ALP、TNF-α、IL-6、IL-8呈现出正相关(r=0.573、0.389、0.315、0.393、0.421、0.389、0.436、0.441、0.598、0.571、0.345、0.370),双歧杆菌、乳杆菌与ALT、AST、ALP、TNF-α、IL-6、IL-8呈现出负相关(r=-0.487、-0.378、-0.347、-0.318、-0.337、-0.330、-0.459、-0.570、-0.502、-0.661、-0.384、-0.418),均有P<0.05。结论乙肝肝硬化患者肠道菌群、肝功能、炎症因子指标均呈现出异常表达,且各项指标间关系密切,临床治疗工作中应当关注。

Objective To study the relationship between intestinal flora and liver function and serum inflammatory factors in patients with hepatitis b cirrhosis.Methods Sixty-five patients with hepatitis b cirrhosis diagnosed and treated in our hospital from April 2016 to April 2019 were included in the study group.In addition,65 healthy volunteers from the outpatient department of our hospital during the same period were included in the study and set as the control group.Alanine transaminase(ALT),Aspartate transaminase(AST),alkaline phosphatase protein(ALP),tumor necrosis factor-morgan(TNF-Morgan),interleukin-6(IL-6)and interleukin-8(IL-8)were compared between the two groups.Differences in levels of IL-8,enterobacteria,enterococcus,bifidobacteria and lactobacillus were compared,and differences in liver function,inflammatory factors and intestinal flora indexes in patients with different liver function grades were compared.Finally,Spearman coefficient was used to analyze the correlation between intestinal flora indexes and liver function and serum inflammatory factors in patients with hepatitis b cirrhosis.Results The levels of alt,AST,ALP,TNF-α,IL-6,IL-8,Enterobacteriaceae and Enterococcus in the observation group were significantly higher than those in the control group(P<0.05).The level of Bifidobacterium and Lactobacillus in the observation group was significantly lower than that in the control group(P<0.05).The levels of alt,AST,ALP,TNF-α,IL-6,IL-8,Enterobacteriaceae and Enterococcus in patients with different liver function grades were lower than Grade A and lower than grade C(P<0.05).The level of bifidobacteria and lactobacilli in patients with different grades of liver function was higher than grade a>grade B>grade C,the difference was statistically significant(P<0.05).After correlation analysis,enterobacteria,enterococcus showed positive correlation with ALT,AST,ALP,TNF-α,IL-6 and IL-8(r=0.573,0.389,0.315,0.393,0.421,0.389,0.436,0.441,0.598,0.571,0.345 and 0.370).Bifidobacterium and lactobacillus were negatively correlated with ALT,AST,ALP,TNF-α,IL-6 and IL-8(r=-0.487,-0.378,-0.347,-0.318,-0.337,-0.330,-0.459,-0.570,-0.502,-0.661,-0.384 and-0.418),all with P<0.05.Conclusion In patients with hepatitis b cirrhosis,intestinal flora,liver function and inflammatory factors are all abnormally expressed,and there is a close relationship between the indicators,which should be paid attention to in clinical treatment.