Preliminary Analysis Of The Intestinal Flora In Patients With Liver Cirrhosis

Objectives Our objectives were to firstly preliminarily explore the difference in the composition of intestinal flora between patients with cirrhosis and healthy people,secondly to preliminarily analyze the respective relationship between intestinal flora and different periods of cirrhosis(compensated or decompensated),different grades of liver function of cirrhosis(Child-Pugh classification),different etiologies of cirrhosis and ascites,and finally to perform simple enterotypes of intestinal flora in patients with cirrhosis for assisting in the diagnosis and assessment of liver cirrhosis and its severity through the detection of intestinal flora.Methods 80 patients diagnosed as cirrhosis and 40 healthy volunteers selected for the same period were included.According to the guidelines for diagnosis and treatment of liver cirrhosis of Chinese Medical Association in 2019:Patients with liver cirrhosis were divided into four sugroups: compensated and decompensated group,Child-Pugh A,Child-Pugh B and Child-Pugh C group,alcoholic liver cirrhosis,HBV-liver cirrhosis,alcoholic cirrhosis and HBV-liver cirrhosis,primary biliary liver cirrhosis and other reason liver cirrhosis group,cirrhosis without ascites and cirrhosis with ascites group.A fecal bacterial genomic DNA extraction kit was used to collect fecal and the intestinal flora was detected by 16 s r DNA sequencing technology whose result was analyzed by QIIME software,R software and so on.Results 1.The species diversity of intestinal flora declined significantly in patients with cirrhosis and was on decline with the severity of cirrhosis and the appearance of ascites compared with control group.2.With the occurrence and the severity of liver cirrhosis,the mean relative abundance percentage of some species of intestinal flora changed.Pathogenic bacteria such as Fusobacteria,Actinobacteria and Proteobacteria increased significantly,while beneficial bacteria such as Bacteroidetes and Verrucomicrobia decreased significantly at the phylum level,and the Firmicutes/Bacteroidetes ratio increased.Pathogenic bacteria such as Escherichia/Shigella,Streptococcus and Veillonela increased significantly,while beneficial bacteria such as Prevotella,Faecalibacterium Roseburia and f__Lachnospiraceae decreased significantly at the genus level.3.The mean relative abundance percentages of Proteobacteria and Escherichia/Shigella showed a significant positive correlation with Child-Pugh scores in patients with cirrhosis.4.No significant differences were observed both in the species diversity of intestinal flora in cirrhosis of different etiologies and in the mean relative abundance percentage of main species.5.People with a intestinal flora structure predominated by Escherichia were at higher risk of developing severe cirrhosis.Conclusions The species diversity of intestinal flora in patients with liver cirrhosis shows a decline with an imbalance of a decrease in some beneficial bacteria and an increase in some pathogenic bacteria.And this situation is more severe with the progression of liver cirrhosis.In addition,Escherichia predominant intestinal flora structure is the dangerous enterotypes of cirrhosis.