Study On Intestinal Barrier Function And Microecology Of Patients With Hepatitis B Virus Cirrhosis

Objective: The study is aiming to explore the relationship between the changes in the structure of the intestinal flora and the development of hepatitis B cirrhosis,then illuminate its clinical significance by analyzing the intestinal mucosal barrier function and microecological changes of patients with hepatitis B virus cirrhosis and compare them with healthy people.Methods: The method is adopted by collecting peripheral blood and fresh feces from 75 patients with hepatitis B cirrhosis and dividing 28 into the compensatory group,47 into the uncompensatory group according to the severity of the disease,meanwhile,peripheral blood and fresh feces were collected from 20 healthy people for testing.Enzymatic methods were performed to detect the biochemical indicators of intestinal barrier function,including diamine oxidase（DAO）,D-lactic acid and endotoxin.16 srDNA sequence Illumina Miseq sequencing was used in the intestinal bacteria sample to analyze and compare the differences in intestinal barrier function and flora structure among the three groups,also,the intestinal species diversity was analyzed.Results: The content of DAO,D-lactic acid and endotoxin of patients with hepatitis B cirrhosis in both compensated and decompensatory groups were higher than those in the control group（2.49±2.13vs2.89±1.36vs2.14±1.01,10.35±3.12vs14.22±2.04vs8.11±3.44,5.12±1.38vs6.38±1.31vs4.22±2.10;P<0.05）,the liver function level indicators ALT and AST were positively correlated with DAO,D-lactic acid and endotoxin（r=0.416,r=0.360,r=0.602;r=0.592,r=0.435,r=0.363）,while ALB was negatively correlated with these three factors（r=-0.428,r=-0.457,r=-0.525）（P<0.05）.Child-Pugh grade and BioClim score were positively correlated with intestinal barrier function indexes of patients with hepatitis B cirrhosis（r=0.425,r=0.561,r=0.438;r=0.314,r=0.507,r=0.510）（P<0.05）.The level of Firmicutes in the c ompensated and decompensated HBV cirrhosis groups was considerably lower than that in the control group（64.27%vs58.73%vs70.98%;P>0.05）,Bacteroidetes were higher than the c ontrol group（24.53%vs29.22%vs19.48%;P>0.05）,and the genus Bacteroides was higher in b oth the compensatory stage group and the decompensated stage group than in the control group（13.62%vs18.50%vs11.65%;P<0.05）.The number of Faecalibacterium in the compens atory period group was higher than that in the control group,whereas it was lower in the decompensated group（11.73%vs9.91%vs10.13%;P>0.05）.The Chao index and Shannon in dex of the control group were higher than those of compensatory group and the decompen sated group（1253.47±114.63vs1021.52±113.47vs912.43±67.84;3.73±0.64vs3.45±0.04vs3.29±0.19;P<0.05）,the Simpson index of the control group was lower than that of compensatory stage group and the decompensated stage group（0.13±0.51vs0.22±0.17vs0.34±0.11;P> 0.05）.Hence,the Lachnoclostridium and Ruminococcaceae Ruminiclostridium₅ in the control gr oup,the Veillonellaceae family Veillonella in the decompensation group played an importan t role in flora differences（|LDA|≥2）.Conclusions: The content of DAO,D-lactic acid and endotoxin in patients with hepatitis B cirrhosis and decompensated patients were more considerable higher than those in the control group,and they were correlated with ALT and AST,and negatively were correlated with ALB.DAO,Dlactic acid and endotoxin indicators have clinical significance in judging the prognosis of patients.The Firmicutes and Bacteroides belong to the absolute superiority in the research samples.As the severity of the disease worsens,the abundance of Firmicutes decreases continuously,and the abundance of Bacteroides increases.The abundance of genus Bacteroides was increased in patients with hepatitis B cirrhosis,and the abundance of Faecalibacterium was increased in patients in the compensatory phase,and the genus Macromonas was slightly decreased;in the decompensated group,the abundance of Faecalibacterium was decreased.Macromonas almost disappeared.The intestinal flora abundance and diversity of patients with hepatitis B cirrhosis were reduced,and there were obvious differences in the intestinal flora at different stages of cirrhosis,besides,the intestinal diversity presented a decrease with disease progression.