A Research On The Changes Of Intestinal Short Chain Fatty Acids In Chronic Severe Hapatitis B Patients

Background and Objective : Chronic hepatitis B is a chronic liver disease and with a high incidence worldwide.Chronic severe hepatitis B(CSHB)patients have a poor prognosis.These patients have a high mortality rate after receiving an integrative treatment.Intestinal short chain fatty acids(SCFAs)are organic acids,which participate in providing energy for enterocytes,reducing intestinal permeability,maintaining intestinal mucosal barrier and regulating intestinal immune system,etc.Besides,SCFAs contribute to the energy supply of the liver.The protective effect of SCFAs in non-alcoholic fatty liver disease has attracted the attention of scholars.However,there is no research on the relationship between CSHB and SCFAs currently.As the level of intestinal SCFAs can be reflected by the fecal SCFAs indirectly,we detect fecal SCFAs levels to find out the difference between the CSHB patients and the control group,aiming at elucidating the role of intestinal SCFAs in the pathophysiology of CSHB.The high performance liquid chromatography technology was used.Method:Twenty-five inpatients diagnosed with CSHB from the People's Hospital of Guangxi Zhuang Automous Region and the Fourth People's Hospital of Nanning were selected as the patient group from Junuary 2013 to December 2015.And fifteen healthy individuals who received a physical examination at the medical examination center of the People's Hospital of Guangxi Zhuang Automous Region were recruited as the control group.We collect the information of the two groups' demographic data,medical history,virus hepatitis' antigen and antibody,abdominal ultrasound,prothrombin time,and so on.Fecal samples of these two groups were collected synchronously,and the levels of fecal acetic acid,propionic acid,butyric acid,isobutyric acid,isovaleric acid and total SCFAs were meassured by high performance liquid chromatography technology.The levels of SCFAs were compared when patients were divided into different groups by the characteristics of encephalopathy,ascites or hepatic reserve.Results: 1.The levels of fecal acetic acid,propionic acid,butyric acid,isobutyric acid,isovaleric acid and total short-chain fatty acids in the CSHB group were lower than those in the healthy individuals.The differences of propionic acid,isovaleric acid and total SCFAs in the CSHB group were significantly lower than the control group.2.In the CSHB group,the levels of acetic acid,propionic acid and total SCFAs of the patients with hepatic encephalopathy were significantly lower than those without hepatic encephalopathy(P<0.05).3.The Child-Pugh C grade patients had lower fecal levels of acetic,propionic,butyric,isobutyric acid and total SCFAs than Child-Pugh B patients.And the acetic acid level of Child-Pugh C group was significantly lower than the Child-Pugh B group(P<0.05).4.In the CSHB group,the levels of all kinds of SCFAs in the ascites group were lower than those in the ascites-free group.However,the differences between the two groups were not statistically significant.Conclusion: 1.The levels of intestinal propionic acid,isovaleric acid and total SCFAs of CSHB patients were lower than those in the normal individuals,which may play a role in the development of chronic severe hepatitis B.2.The levels of intestinal acetic acid,propionic acid and total SCFAs of the CSHB patients with hepatic encephalopathy were lower than those without hepatic encephalopathy,which may which may be associated with the pathogenesis of hepatic encephalopathy.3.The Child-Pugh C group has a lower level of intestinal acetic acid than the Child-Pugh B group in CSHB patients,which indicates that the level of intestinal acetic acid can reflect patients' hepatic reserve to some extent.