慢性乙型肝炎患者TBIL、ALT、γ-GT、TBA水平变化及肠道菌群分析

Changes of TBIL, ALT, γ-GT and TBA levels and intestinal flora in patients with chronic hepatitis B

目的研究慢性乙型肝炎患者总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、γ-谷氨酰转肽酶(γ-GT)、总胆汁酸(TBA)水平及肠道菌群变化。方法选取2017年10月至2018年10月我院收治的慢性乙型肝炎患者80例为观察组,选取同期来我院进行体检的100例健康者为对照组,对比两组对象肝功能指标、血清炎性因子水平和肠道菌群数量。结果观察组患者血清TBIL、ALT、TBA和γ-GT水平显著高于对照组(均P<0.05)。观察组患者血清CRP、TNF-α和IL-6水平显著高于对照组(均P<0.05)。观察组患者肠道肠杆菌科、普雷沃菌属、拟杆菌属、梭菌属细菌及白假丝酵母数量显著高于对照组(均P<0.05)。两组对象肠道瘤胃球菌属、双歧杆菌属、乳杆菌属细菌及粪肠球菌数量差异无统计学意义(均P>0.05)。结论慢性乙型肝炎患者TBIL、ALT、γ-GT、TBA水平高于健康人群,炎性因子水平也高于正常人群,且存在一定程度的肠道菌群失调。提示肠道菌群结构变化可能对肝脏组织产生一定的损伤。

Objective To explore the changes of TBIL,ALT,γ-GT and TBA levels and intestinal flora in patients with chronic hepatitis B.Methods Eighty patients with chronic hepatitis B admitted to our hospital from October 2017 to October 2018 were enrolled as the observation group,with 100 healthy individuals who underwent physical examination in the same period as the control group.The liver function indexes,serum inflammatory factor levels and number of intestinal flora were compared between the two groups.Results The serum levels of TBIL,ALT,TBA andγ-GT,the serum levels of CRP,TNF-αand IL-6,and the numbers of intestinal Enterobacter,Prevotella,Bacteroides,Clostridium and Candida albicans in the observation group were significantly higher than those in the control group,respectively(all P<0.05).There were no significant differences in the numbers of Rumen,Bifidobacterium,Lactobacillus and Enterococcus faecalis between the two groups(all P>0.05).Conclusion The levels of TBIL,ALT,γ-GT and TBA in patients with chronic hepatitis B are higher than those in healthy population,so are the levels of inflammatory factors.There is a certain degree of intestinal flora imbalance in the patients,suggesting that changes in intestinal flora structure may cause certain damage to liver tissue.