乙型肝炎患者肠道菌群特征的Meta分析

Meta-analysis of Intestinal Microflora Characteristics in Patients with Hepatitis B

目的:系统评价乙肝病毒感染(HBV)患者与正常人群相比肠道菌群数量和微生物多样性的变化,为乙肝的临床治疗提供新方法。方法:检索CNKI、万方、维普、CBM、Pubmed、The Cochrane Library、web of science数据库,检索时限均为2002年1月1日至2022年3月26日,使用Revman5.4和Stata14.0软件进行Meta分析。结果:本研究共纳入14篇文献,纳入对象1586例,其中病例组927例,对照组659例。与正常人群相比肠杆菌科(MD=0.72,95%CI:0.53~1.05,P<0.05)、普雷沃氏菌属(MD=1.34,95%CI:1.08~1.60,P<0.05)、梭菌属(MD=1.90,95%CI:1.72~2.08,P<0.05)、肠球菌(MD=1.19,95%CI:0.98,1.41,P<0.05)HBV肠道菌群数量增多;乳杆菌(MD=-1.21,95%CI:-1.77~-0.66,P<0.05)、瘤胃球菌(MD=-0.81,95%CI:-1.29~-0.34,P<0.05)HBV肠道菌群数量降低。拟杆菌属(MD=-0.53,95%CI:-1.22~0.15,P=0.13)、双歧杆菌(MD=-0.67,95%CI:-2.14~0.80,P=0.57)差异无统计学意义。微生物α多样性:Chao1指数乙肝组低于正常组(MD=-29.17,95%CI:-37.96~-20.38,P<0.05)。Shannon(MD=0.12,95%CI:-0.20~0.45,P=0.46)和Simpson指数(MD=0.02,95%CI:-0.04~0.08,P=0.50)差异无统计学意义。结论:本研究显示HBV患者梭菌属、普雷沃氏菌属、肠球菌和肠杆菌科升高,乳杆菌和瘤胃球菌下降,HBV患者肠道微生物多样性与正常人群相比有差异。

Objective:To systematically evaluate the difference in intestinal microflora content,abundance and diversity between hepatitis B patients and healthy people,to provide a new approach to the clinical treatment of hepatitis B.Methods:A comprehensive search was conducted by CNKI,Wanfang,VIP,CBM,PubMed,The Cochrane Library and Web of Science to find case-control studies relating to the intestinal flora of patients with hepatitis B.The retrieval period was from Jan 1,2002 to Mar 26,2022.Meta-analysis was performed using Revman5.4 and Stata14.0.Results:A total of 1,586 subjects were included in 14 literatures,including 927 cases in the case group and 659 cases in the control group.Compared with healthy controls,Meta-analysis showed that the hepatitis B had a higher quantity of Enterobacteriaceae[MD=0.72,95%CI:(0.53,1.05),P<0.05],Prevotella[MD=1.34,95%CI:(1.08,1.60),P<0.05],Clostridium[MD=1.90,95%CI:(1.72,2.08),P<0.05],Enterococcus[MD=1.19,95%CI:(0.98,1.41),P<0.05].In contrast,the hepatitis B had a lower quantity of Lactobacillus[MD=-1.21,95%CI:(-1.77,-0.66),P<0.05]and Ruminococcus[MD=-0.81,95%CI:(-1.29,-0.34),P<0.05].There were no significant changes in Bacteroides[MD=-0.53,95%CI:(-1.22,0.15),P=0.13]and Bifidobacterium[MD=-0.67,95%CI:(-2.14,0.80),P=0.57],chao1 index of hepatitis b group was lower than healthy controls[MD=-29.17,95%CI:(-37.96,-20.38),P<0.05].Shannon[MD=0.12,95%CI:(-0.20,0.45),P=0.46]and Simpson index[MD=0.02,95%CI:(-0.04,0.08),P=0.50]had no significant difference.Conclusion:In this study,Clostridium,Prevotella,Enterococcus and Enterobacteriaceae increased in HBV patients,while Lactobacillus and Ruminococcus decreased,the intestinal microbial diversity of HBV patients was different from that of the normal population.