慢性乙型肝炎以及肝硬化患者肠道微生物研究

发布时间：2018-02-28 00:05

本文关键词： 慢性乙型肝炎肠道微生物肝功能细胞因子　出处：《安徽医科大学学报》2015年05期 　论文类型：期刊论文

【摘要】：目的探讨慢性乙型肝炎以及肝硬化患者的肠道菌群变化及其与细胞因子、肝功能之间的关系。方法选取30例健康志愿者、50例肝炎后肝硬化患者以及50例慢性乙型肝炎患者,采用实时荧光定量PCR法检测粪便中九种肠道菌群含量,比较三组间肠道菌群变化;同时采用ELISA法检测慢性乙型肝炎患者血清中细胞因子如白介素-17A(IL-17)、白介素-1β(IL-1β)、白介素-6(IL-6)、干扰素-α(INF-α)、CXC趋化因子(CXCL-13)的浓度,分析肠道菌群与细胞因子以及肝功能之间的关系。结果与健康对照组相比,慢性乙型肝炎以及肝硬化患者体内的双歧杆菌、乳酸杆菌、拟杆菌属以及瘤胃球菌属含量减少;肠杆菌科细菌、肠球菌、梭菌属、白色念珠菌以及普雷沃氏菌含量明显增加。慢性乙型肝炎患者体内的肠杆菌科细菌与凝血酶原时间(PT)呈正相关性,肠球菌与谷丙转氨酶(ALT)、谷草转氨酶(AST)呈正相关性;双歧杆菌与AST、碱性磷酸酶(AKP)以及HBV DNA水平呈负相关性,普雷沃氏菌属与AST、AKP以及PT呈负相关性,拟杆菌属与AST和PT呈负相关性,瘤胃球菌属与白蛋白(ALB)呈负相关性。另外,9种肠道菌群中只有肠球菌与IL-17A呈正相关性。结论慢性乙型肝炎以及肝硬化患者体内存在不同程度的肠道菌群失调,其中乙肝患者体内过度繁殖的肠球菌与IL-17A协同参与肝脏炎症反应过程,以致于肝功能受损呈恶性循环状态。
[Abstract]:Objective to investigate the changes of intestinal flora and their relationship with cytokines and liver function in patients with chronic hepatitis B and cirrhosis. Methods 30 healthy volunteers were selected from 50 patients with posthepatitic cirrhosis and 50 patients with chronic hepatitis B. The contents of nine kinds of intestinal microflora in feces were detected by real-time fluorescence quantitative PCR, and the changes of intestinal flora were compared among the three groups. At the same time, serum cytokines such as interleukin-17 (IL-17), interleukin-1 尾 (IL-1 尾), interleukin-6 (IL-6), interferon- 伪 (INF- 伪) -CXC chemokine (CXCL-13) were detected by ELISA assay in patients with chronic hepatitis B. Results compared with the healthy control group, the contents of Bifidobacterium, Lactobacillus, Bacillus, Bacteroides and Rumen Staphylococcus in patients with chronic hepatitis B and cirrhosis were decreased. The contents of Enterobacteriaceae, Enterococcus, Clostridium, Candida albicans and Prevoc were significantly increased. There was a positive correlation between Enterobacteriaceae and prothrombin time (PTT) in patients with chronic hepatitis B. There was a positive correlation between Enterococcus and alanine aminotransferase (alt), a negative correlation between Bifidobacterium and AST, alkaline phosphatase (ALK) and HBV DNA levels, a negative correlation between Prevobacter and AST AKP and PT, a negative correlation between Bacteroides and AST and PT, and a negative correlation between Bifidobacterium and AST, alkaline phosphatase (ALP) and HBV DNA. In addition, only Enterococcus had positive correlation with IL-17A in 9 intestinal flora. Conclusion there are different degrees of intestinal dysbacteriosis in patients with chronic hepatitis B and liver cirrhosis. Enterococci and IL-17A co-participate in the process of liver inflammation in patients with hepatitis B, resulting in a vicious circle of liver function damage.
【作者单位】：安徽医科大学第一附属医院感染科;安徽省细菌耐药监控中心;合肥市第一人民医院感染科;
【基金】：国家自然科学基金(编号:81172737)
【分类号】：R512.62

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