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慢性丙型肝炎患者结肠微生物群落失调的评估。

ASSESSMENT OF COLON MICROBIOCENOSIS DISORDERS IN PATIENTS WITH CHRONIC HEPATITIS C.

机构信息

UZHHOROD NATIONAL UNIVERSITY, UZHHOROD, UKRAINE.

SHUPYK NATIONAL HEALTHCARE UNIVERSITY OF UKRAINE, KYIV, UKRAINE.

出版信息

Wiad Lek. 2022;75(10):2334-2338. doi: 10.36740/WLek202210104.

Abstract

OBJECTIVE

The aim: To investigate the peculiarities of colon microbiocenosis disorders in patients with chronic hepatitis C.

PATIENTS AND METHODS

Materials and methods: 142 patients with CHC were under observation, determination of the degree of liver fibrosis (FibroMax), bacteriological examination of stools and pancreatic elastase was performed.

RESULTS

Results: It was found that 59.2% of patients with CHC had gut dysbiosis (DB), of which 61.9% had increased body weight. Intestinal microbiocenosis disorders were manifested by constipation in 57.1% of patients, diarrhea in 31% of patients, and alternating constipation and diarrhea in 11.9% of patients. Bacteriologically, gut dysbiosis was character¬ized by suppression of the growth of normal microflora: Escherichia coli in 47.6%, bifidobacteria in 61.9%, lactobacilli in 53.6%, complete absence of bifidobacteria in 20.2% of cases. In patients with CHC combined with DB deep stages of liver fibrosis (F2-3 and F3-4) are registered 3.6 times more often compared to patients without intestinal dysbiosis (53.6% versus 24.1% and 11.9% versus 3.4%). The degree of gut DB increased in proportion to the stage of liver fibrosis (p<0.05). 32.1% of patients with CHC with dysbiosis were diagnosed with exocrine insufficiency of the pancreas.

CONCLUSION

Conclusions: Gut dysbiosis occurs more often in CHC patients with increased body weight and is characterized by constipation in 59.2% of patients. Intestinal microbiocenosis is characterized by suppression of the growth of normal microflora. In 32.1% of CHC patients with intestinal dysbiosis, according to the results of the pancreatic elastase-1 test, pancreatic exocrine insufficiency of various degrees was found.

摘要

目的

研究慢性丙型肝炎患者结肠微生物群落紊乱的特点。

患者和方法

观察了 142 例慢性丙型肝炎患者,测定了肝纤维化程度(FibroMax),进行了粪便和胰腺弹性蛋白酶的细菌学检查。

结果

发现 59.2%的慢性丙型肝炎患者存在肠道菌群失调(DB),其中 61.9%的患者体重增加。肠道微生物群落紊乱的表现为 57.1%的患者便秘,31%的患者腹泻,11.9%的患者便秘和腹泻交替。细菌学上,肠道菌群失调的特征是正常微生物群的生长受到抑制:大肠杆菌 47.6%,双歧杆菌 61.9%,乳酸杆菌 53.6%,双歧杆菌完全缺失 20.2%。在慢性丙型肝炎合并 DB 的患者中,肝纤维化深度(F2-3 和 F3-4)的发生率比无肠道菌群失调的患者高 3.6 倍(分别为 53.6%比 24.1%和 11.9%比 3.4%)。肠道 DB 的程度与肝纤维化的阶段成正比(p<0.05)。32.1%的慢性丙型肝炎伴菌群失调的患者被诊断为胰腺外分泌功能不全。

结论

体重增加的慢性丙型肝炎患者更常发生肠道菌群失调,其中 59.2%的患者表现为便秘。肠道微生物群落失调的特征是正常微生物群的生长受到抑制。在 32.1%的慢性丙型肝炎伴肠道菌群失调的患者中,根据胰腺弹性蛋白酶-1 试验的结果,发现了不同程度的胰腺外分泌功能不全。

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