| Objective: To analyze and explore the changes of intestinal barrier function indicat ors and intestinal flora as well as blood microbiota in different patients by comparing th e changes of intestinal barrier function indicators and intestinal flora in patients with he patitis B cirrhosis(hepatitis B cirrhosis),patients with viral hepatitis B(hepatitis B)and normal population,to find intestinal barrier dysfunction in patients with hepatitis B cirrh osis with This will help the clinic to provide preliminary intervention targets to prevent t he progression and treatment of hepatitis B cirrhosis patients.Methods: 1.98 cases of hepatitis B cirrhosis patients,31 cases of hepatitis B patie nts and 41 cases of health checkups in our hospital were tested for intestinal fatty acid bi nding protein(I-FABP)(FABP2),diamine oxidase(DAO)and endotoxin.2.34 cases of feces from hepatitis B cirrhosis patients and 20 cases of feces from normal population were collected.The real-time quantitative PCR analysis of Bacillus and Bifidobacterium in feces was performed in 20 cases of feces from patients with hepatitis B cirrhosis and10 cases of blood from normal population.Results: 1.There were more male than female population in the enrolled study sub jects,and the differences in age,glutamic aminotransferase(ALT),glutamic aminotrans ferase(AST),total bilirubin(TBIL),albumin(ALB),red blood cells(RBC),hemoglobi n(HGB),white blood cells(WBC),platelets(PLT),INR,and prothrombin prolongation time(PT)between the groups were statistically significant,while creatinine(Cr)and po tassium ion(K+)were statistically not significantly different.2.Compared with the healt hy control group,the levels of three indexes,I-FABP,DAO and endotoxin,were signifi cantly higher in the hepatitis B group and the hepatitis B cirrhosis group,and all of them were statistically significant(P < 0.001),while in the hepatitis B group,although I-FA BP,DAO and endotoxin were smaller than 3.With the increase of Child-Pugh grade,th e levels of I-FABP,DAO and endotoxin also increased gradually,and there was statistic al significance among all groups(P < 0.001),and I-FABP,DAO and endotoxin were po sitively correlated with Child-Pugh grade(r=0.349).**,r=0.353**,r=0.505**).4 The A UC of I-FABP for intestinal barrier function disruption in patients with hepatitis B cirrh osis was 0.925(95% confidence interval 88.2%-96.9%,P<0.001),and the AUC of DA O for intestinal barrier function disruption in patients with hepatitis B cirrhosis was 0.927(95% confidence p<0.001),and the AUC of endotoxin for disruption of intestinal barri er function in patients with hepatitis B cirrhosis was 0.844(95% confidence interval 73.3%-95.6%,p<0.001).The AUC for the combined diagnosis of the three indices for disr uption of intestinal barrier function in patients with hepatitis B cirrhosis was 0.995(95% confidence interval 98.7%-100%,P < 0.001).The optimal cut-off points of I-FABP,DAO and endotoxin for the combined diagnosis of the three indices were 1558.88 pg/ml,19.53 ng/ml and 20.66 pg/ml.the sensitivity of the combined diagnosis of intestinal bar rier function disruption in hepatitis B cirrhosis at this time was 87% and the specificity was 98%.the effect of I-FABP,DAO and endotoxin on the The diagnostic value of I-F ABP and DAO was higher than that of endotoxin,and the combined diagnosis was bette r than each index alone.5 The three indexes of I-FABP,DAO and endotoxin were positi vely correlated with blood bilirubin,ghrelin,glutamic oxalacetic transaminase and proth rombin prolongation time(r=0.169*,r=0.160*,r= 0.273**,r=0.207**,r=0.201**,r=0.337**,r=0.182*,r=0.240**,r=0.379**,r=0.326**,r=0.338**,r=0.361**),and negatively cor related with albumin and platelets(r=-0.235**,r=-0.240**,r=-0.267**,r=-0.388**,r=-0.398**,r=-0.325**),so the intestinal barrier function indexes were negatively correlated with liver function.6.Compared with the healthy control group,the fecal content of bifi dobacteria and anaphylactic bacteria in the hepatitis B cirrhosis group was decreased,an d the difference was statistically significant(P<0.05).7.The absolute quantitative values of blood E.coli in patients with hepatitis B cirrhosis were significantly higher than thos e in the healthy control group,and the absolute quantitative values of blood E.coli in th e two groups were statistically different(P < 0.001)。Conclusion: patients with hepatitis B cirrhosis have intestinal barrier dysfunction a nd the degree of impairment of intestinal barrier function varies with different stages of hepatitis B cirrhosis.i-FABP,DAO and endotoxin are complementary in the value of d iagnosing intestinal barrier function in patients with hepatitis B cirrhosis,while i-FABP,DAO and endotoxin are positively correlated,and in the analysis of the study of hepatit is B There is a synergistic trend in the role of elevated intestinal barrier dysfunction cur ves in patients with liver cirrhosis.Combining the three indices for the diagnosis of inte stinal barrier function in patients with hepatitis B cirrhosis will enhance the early warnin g value of intestinal barrier function monitoring.The levels of two probiotics,Bifidobac terium and Bacillus mimicus,were significantly decreased in the intestinal flora of patie nts with hepatitis B cirrhosis.The absolute quantitative values of blood E.coli in patient s with hepatitis B cirrhosis were significantly higher than those in healthy controls,thus bacteria in the intestine of patients with hepatitis B cirrhosis appeared to be partially tra nslocated to the blood through the damaged intestinal mucosal barrier,which again verif ied the presence of intestinal barrier dysfunction in the course of hepatitis B cirrhosis fr om the side. |
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