Biological And Mechanical Changes Of Intestinal Barrier In Patients With Hepatic Cirrhosis And The Value Of Probiotics To Interven

ObjectiveTo investigate the changes of intestinal flora, intestinal barrier permeability, endotoxin level of patients with hepatic cirrhosis and the value of probiotics to intervene.MethodsTwenty-four healthy volunteers and fifty-seven patients with hepatic cirrhosis were enrolled into our study. Patients with hepatic cirrhosis were randomly divided into control group of 25 patients and test group of 32 patients. Control group and test group were received the same treatment, sush as drugs of liver protection and diuretics. In addition, patients of the test group were given Bifid Triple Viable Capsules for 8 weeks. Compared intestinal flora, urinary ratio of lactulose to mannitol, and endotoxin levels of the healty group and the cirrhosis group as well as the control group and the test group.Results1. Endotoxin level, urinary ratio of lactulose to mannitol, Enterobacter, Staphylococcus aureus and Clostridium of cirrhosis group were significantly higher than the healthy group, while Bifidobacterium, Lactobacillus were lower than the healthy group (P<0.05).2. The levels of endotoxin and urinary ratio of lactulose to mannitol in cirrhosis patients with complication were higher than those cirrhosis patients without complications(P<0.05).3. Endotoxin levels and Child-Pugh classification were positive correlation (P<0.05).4. There was no significant difference on urinary ratio of lactulose to mannitol, endotoxin level and intestinal flora between the control group and the test group before the treatment (P>0.05).Urinary ratio of lactulose to mannitol, endotoxin level, Enterobacter, Staphylococcus aureus and Clostridium of the test group were significantly lower than the control group after the treatment, however, Bifidobacterium and Lactobacillus levels of the test group were significantly higher than the control group roup (P<0.05).5. The number of cases of the control group and the test group at all levels of Child-Pugh classification had no significant difference befor the treatment (P>0.05). The number of Grade A of control group reduced, but the number of grade B increased. The difference was statistically significant (P<0.05).ConclusionThere were imbalance of intestinal flora, increasing of intestinal permea-bility and high endotoxinxemia in patients with hepatic cirrhosis. There were closely relation of high endotoxemia and liver injury, the development of liver cirrhosis condition and the occurence of life-threatening complication. Probiotics could regulate the intestinal flora, improve intestinal barrier function, reduce intestinal permeability and endotoxin levels, thus contributing to delay further deterioration of liver function and the development of various complication in patients with liver cirrhosis.