中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 4
Apr.  2016

Relationship between small intestinal bacterial overgrowth and severity of with hepatitis B cirrhosis

DOI: 10.3969/j.issn.1001-5256.2016.04.021
  • Published Date: 2016-04-20
  • Objective To investigate the relationship between small intestinal bacterial overgrowth( SIBO) and the severity of hepatitis B cirrhosis. Methods Forty- seven patients with hepatitis B cirrhosis who visited Department of Gastroenterology,Zhengzhou People's Hospital,from June 2014 to June 2015 were selected as cirrhosis group; these patients consisted of 11 Child- Pugh class A cases,16 Child-Pugh class B cases,and 20 Child- Pugh class C cases. Fifteen healthy volunteers were selected as control group. The levels of procalcitonin,bilirubin,plasma albumin,and globulin were measured in all subjects. The lactulose hydrogen breath test( LHBT) was performed to measure small intestinal bacterial growth. Comparison of categorical data was made by chi- square test or Fisher's exact test. Comparison of normally distributed continuacs data between groups was performed by t test,The correlations of SIBO with procalcitonin,bilirubin,plasma albumin,and albumin / globulin ratio were investigated by Pearson correlation analysis. Results SIBO was found in 22( 46. 8%) of the 47 patients with liver cirrhosis,consisting of 2( 18. 1%) in the 11 Child- Pugh class A cases,7( 43. 7%) in the 16 Child- Pugh class B cases,and 13( 65. 0%) in the 20 Child- Pugh class C cases. The prevalence of SIBO showed a significant difference between the controls and all patients with hepatitis B cirrhosis,Child- Pugh class B cases,or Child- Pugh class C cases( P = 0. 005,0. 037,or 0. 001),but no significant difference between the controls and Child- Pugh class A cases( P = 0. 556); there was a significant difference in the prevalence of SIBO between Child- Pugh class A cases and Child- Pugh class B / C cases( χ~2= 4. 727,P = 0. 030). The levels of procalcitonin,bilirubin,plasma albumin,and globulin were significantly correlated with LHBT set- value( r = 0. 895,0. 907,- 0. 810,and 0. 755,respectively,all P < 0. 001). Conclusion The prevalence of SIBO increases with exacerbation of liver injury in patients with hepatitis B cirrhosis. The levels of procalcitonin,bilirubin,and globulin are positively correlated with SIBO,while plasma albumin level is negatively correlated with SIBO.

     

  • [1]CHEN YF,WU ZJ.Pathogenesis and risk factors of cholesterol gallstones in patients with non-alcoholic fatty liver disease[J].J Clin Hepatol,2013,29(12):952-955.(in Chinese)陈永芳,吴战军.非酒精性脂肪性肝病患者并发胆固醇性胆结石的发病机制及危险因素[J].临床肝胆病杂志,2013,29(12):952-955.
    [2] Chinese Society of Hepatology and Chinese Society of Infectious Diseases,Chinese Medical Association.The guideline of prevention and treatment for chronic hepatitis B(2010 version)[J].J Clin Hepatol,2011,27(1):Ⅰ-ⅩⅥ.(in Chinese)中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2010年版)[J].临床肝胆病杂志,2011,27(1):Ⅰ-ⅩⅥ.
    [3]PANDE C,KUMAR A,SARIN SK.Small-intestinal bacterial overgrowth in cirrhosis is related to the severity of liver disease[J].Aliment Pharmacol Ther,2009,29(12):1273-1281.
    [4]LOMBARDO L,FOTI M,RUGGIA O,et al.Increased incidence of small intestinal bacterial overgrowth during proton pump inhibitor therapy[J].Clin Gastroenterol Hepatol,2010,8(6):504-508.
    [5]ZHOU HY,ZHOU GH,LENG MF,et al.A study on small intestinal bacterial overgrowth in patients with cirrhosis[J].Chin J Diffic and Compl Cas,2011,10(3):185-187.(in Chinese)周红宇,周国华,冷明芳,等.肝硬化小肠细菌过度生长情况分析[J].疑难病杂志,2011,10(3):185-187.
    [6]MORENCOS FC,de LAS HERAS CG,MARTIN RL,et al.Small bowel bacterial overgrowth in patients with alcoholic cirrhosis[J].Dig Dis Sci,1995,40(6):1252-1256.
    [7]YANG CY,CHANG CS,CHEN GH.Small-intestinal bacterial overgrowth in patients with liver cirrhosis,diagnosed with glucose H2or CH4 breath tests[J].Scand J Gastroenterol,1998,33(8):867-871.
    [8]WILBERG S,PIERAMICO O,MALFERTHEINER P.The H2-lactulose breath test in the diagnosis of intestinal transittime[J].Leber Magen Darm,1990,20(3):129-137.
    [9]CAO SG,WU H,XU CL,et al.Effects of small intestinal bacterial overgrowth on bowel gas production in patients with liver cirrhosis[J].Chin JHepatol,2010,18(11):864-865.(in Chinese)曹曙光,吴昊,徐昌隆,等.肝硬化患者小肠细菌过度生长在肠道气体产生中的作用[J].中华肝脏病杂志,2010,18(11):864-865.
    [10]LI SL,LIU XJ,ZHOU HT.The relation between hepatic cirrhosis and small intestine bacterial overgrowth[J].China Modern Med,2014,21(35):58-60.(in Chinese)李山林,刘学进,周洪涛.肝硬化与小肠细菌过度生长的关系[J].中国当代医药,2014,21(35):58-60.
    [11]CHEN CY,LU CL,CHANG FY,et al.Delayed gastrointestinal transit in patients with hepatocellular carcinoma[J].J Gastroenterol Hepatol,2002,17(12):1254-1269.
    [12]MORGENTHALER NG,STRUCK J,CHANCERCLLE Y,et al.Production of procalcitonin(PCT)in non-thyroidal tissue after LPS injection[J].Horm Metab Res,2003,35(5):290-295.
    [13]The Organize of the Expert Consensus on the Clinical Application of Procalcitonin in Emergency.The expert consensus on the clinical application of procalcitonin in emergency[J].Chin J Emerg Med,2012,21(9):944-951.
    [14]CONNERT S,STREMMEL W,ELSING C.Procalcitonin is a valid marker of infection in decompensated cirrhosis[J].Z Gastroenterol,2003,41(2):165-170.
    [15]LESINSKA M,HARTLEB M,GUTKOWSKI K,et al.Procalcitonin and macrophage inflammatory protein-1 beta(MIP-1β)in serum and peritoneal fluid of patients with decompensated cirrhosis and spontaneous bacterial peritonitis[J].Adv Med Sci,2014,59(1):52-56.
    [16]BOTA DP,van NUFFELEN M,ZAKARIAH AN,et al.Serum levels of C-reactive protein and procalcitonin in critically ill patients with cirrhosis of the liver[J].J Lab Clin Med,2005,146(6):347-351.
  • Cited by

    Periodical cited type(12)

    1. 刘璨宇,韩际奥,王会敏,马英杰. 低FODMAP饮食对肝硬化患者胃肠道症状的影响. 胃肠病学和肝病学杂志. 2021(06): 682-687 .
    2. 曹莉婷,孙瑾瑜,李初谊,黄新霞,于晓辉. 肝硬化与小肠细菌过度生长的研究进展. 宁夏医科大学学报. 2021(08): 870-875 .
    3. 高玉华,王兵亮,刘丽. 益气解毒通络方联合恩替卡韦对乙肝肝硬化患肝功能及CTGF、PDGF水平的影响. 现代医学与健康研究电子杂志. 2020(08): 127-128 .
    4. 王志豪,龙婷,陈秀,李作孝. 益生菌对EAE小鼠肠道菌群及TLR4/NF-κB信号通路的影响. 中国免疫学杂志. 2020(23): 2822-2827+2831 .
    5. 陈颖,陈世耀. 小肠细菌过度生长与慢性肝病. 上海医药. 2019(15): 3-6+47 .
    6. 高晓. 香连平胃散加减治疗肝硬化且小肠细菌过度生长观察. 河南医学高等专科学校学报. 2019(06): 767-770 .
    7. 黄蓉,倪加加,高毅. 肠道菌群-脂多糖-Toll样受体4轴与肝细胞癌的关系. 临床肝胆病杂志. 2018(06): 1325-1328 . 本站查看
    8. 宋洁,张慧敏,王佳林. 肝硬化病人小肠细菌过度生长情况与肝功能、自发性腹膜炎的相关性. 内蒙古医科大学学报. 2018(02): 147-151 .
    9. 许洁娜,陈祺,吴海恩,尹合坤. 氢呼气试验在肝硬化患者肠道微环境测定中的应用研究. 黑龙江中医药. 2018(06): 205-207 .
    10. 詹金美,林欢,孙家敏. 定量检测血清降钙素原在诊断肝衰竭患者腹腔感染细菌类型中的价值. 中外医疗. 2017(28): 34-36 .
    11. 王传敏,孟忠吉,陈悦,刘莉. 血清降钙素原检测对肝衰竭合并感染的早期诊断价值. 临床肝胆病杂志. 2017(06): 1137-1140 . 本站查看
    12. 姜冰. 肝硬化患者胆囊结石发病率及其与肝脏疾病进展的相关性. 中国实用医药. 2017(35): 53-54 .

    Other cited types(6)

  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (2509) PDF downloads(401) Cited by(18)
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return