Study On The Changes Of Intestinal Flora Structure In Patients With Chronic Liver Disease At High Altitude

Objective To investigate the species diversity and abundance structure of intestinal flora in patients with chronic liver disease at high altitude.Methods:From January 2021 to may 2021,90 patients with chronic liver disease who were treated in the Affiliated Hospital of Qinghai University and lived in the local area(altitude > 2260m)for more than 10 years and 25 healthy people in the physical examination center were studied.Chronic liver disease group includes30 cases of chronic hepatitis B,30 cases of liver cirrhosis caused by hepatitis B,and30 cases of primary liver cancer(excluding other causes of hepatitis B virus infection).Through high-throughput sequencing and bioinformatics analysis technology,to explore the changes of species diversity between patients with chronic liver disease and healthy people and whether there are differences in intestinal flora composition at different classification levels,and to explore the correlation between intestinal flora abundance and serum liver function indexes at the genus level.Results : Compared with the healthy control group,the intestinal microecological diversity of patients with chronic liver disease decreased at the level of OTU(Z= 1.462,P = 0.005),β Diversity analysis showed that there were differences in the composition of intestinal flora between patients with chronic liver disease and healthy people(r = 0.122,P = 0.020).By analyzing the difference of intestinal flora between chronic liver disease group and healthy control group,it was found that Bacteroidetes were relatively enriched in chronic liver disease group(Z =0.1.065,P = 0.043);There was no significant difference in portal level between chronic hepatitis B,hepatitis B cirrhosis and primary liver cancer(P > 0.05).At the genus classification level,compared with the healthy control group,faecalis was enriched in the chronic liver disease group(Z = 1.092,P = 0.032),and the distribution of Enterococcus was reduced(Z= 1.398,P = 0.036);In addition,it was found that some potential pathogenic bacteria such as Streptococcus and veroniella in the chronic liver disease group were more abundant than those in the healthy group,while the relative abundance of probiotics such as bifidobacteria and Lactobacillus was low,but there was no significant difference between the groups(P > 0.05).Group comparison showed that the distribution of Streptococcus and rongella in each group was different(P < 0.05).Compared with 22 different strains,it was found that compared with primary liver cancer group,streptococcus was more enriched in hepatitis B cirrhosis group(P < 0.05).It was also found that compared with the chronic hepatitis B group,the abundance of Veillonella in the hepatitis B cirrhosis and hepatocellular carcinoma groups was higher,however,the difference was not statistically significant.Correlation analysis showed that faecalis was positively correlated with ALT,AST and ALP(r = 0.192,0.187,0.276,P < 0.05),and veroniella was positively correlated with TB and ALP(r = 0.257,0.225,P <0.05).Conclusions:1.At the OTU level,the intestinal microbial diversity of patients with chronic liver disease was significantly lower than that of healthy people,and there were differences in the composition and structure of intestinal flora between patients with chronic liver disease and healthy people.2.The composition and structure of intestinal flora in patients with chronic liver disease have changed compared with healthy people.The up regulation of a variety of potential pathogens was detected by describing the species and abundance of flora.In addition,some potential pathogenic bacteria such as Streptococcus and veroniella are more concentrated in patients with hepatitis B cirrhosis.3.Correlation analysis showed that faecalis was positively correlated with serum biochemical indexes such as glutamic oxaloacetic transaminase,alanine aminotransferase and alkaline phosphatase,and veroniella was positively correlated with total bilirubin and alkaline phosphatase.Intestinal microecological imbalance and destruction of intestinal barrier played a key role in the pathogenesis of chronic liver disease.