Characteristics of intestinal flora before and after transjugular intrahepatic portosystemic shunt in patients with liver cirrhosis

Objective To investigate the characteristics of flora microbiota before and after transjugular intrahepatic portosystemic shunt( TIPS) in patients with liver cirrhosis. Methods A total of 18 patients with liver cirrhosis who were hospitalized and underwent TIPS in Department of Gastroenterology,The Affiliated Hospital of Southwest Medical University,from July 2018 to July 2019 were enrolled. Fecal samples were collected from 18 patients before surgery,6 fecal samples were collected at 1 month after surgery,and 9 were collected at 3 months after surgery. The results of liver function and coagulation were collected before and after surgery. Fecal samples were analyzed by the 16 S rRNA high-throughput sequencing method,and the DADA2 method recommended by QIIME2 was used in the bioinformatics analysis. The intestinal flora was analyzed in terms of the generated amplified characteristic sequence,and the multiple hypothesis tests of LEfSe,SPSS( Alpha analysis),PERMANOVA( Beta analysis),and Pheatmap were used for analysis. For normally distributed continuous data,intergroup comparison of parameters at different time points was made by a repeated measures analysis of variance. For non-normally distributed continuous data,intergroup comparison of parameters at different time points was made using a generalized estimating equation,and further pairwise comparison was made using the Bonferroni method. Results There were significant differences in total bilirubin and total bile acid between groups before TIPS and during the three periods of time after TIPS( F = 8. 201 and 39. 482,P = 0. 001 and P < 0. 001).At 1 month after surgery,Beta diversity changes were observed in fecal samples( F = 2. 603,P = 0. 02),while there was no significant difference in Alpha diversity of the fecal samples between the three periods of time( P > 0. 05). At the genus level,portal venous pressure before TIPS was negatively correlated with Bifidobacterium,Collinsella,and Ruminococcus( r =-0. 35,-0. 38,and-0. 34,P = 0. 04,0. 02,and 0. 04) and was positively correlated with Boletus( r = 0. 41,P = 0. 015). Other indices were also correlated with different components of the intestinal flora( P < 0. 05). Conclusion There is a correlation between clinical indices and intestinal flora before TIPS. The composition of intestinal flora changes after TIPS,with a significant difference at the genus level.