Study on the changes of the intestinal flora in patients with chronic severe hepatitis

Objective To investigate the changes of intestinal flora in patients with chronic severe hepatitis and the relationship between the disorder extent of flora and the levels of endotoxin in the blood. Methods Fecal flora of the subjects were quantitatively and qualitatively analyzed by Mitsuoka's methods. Meanwhile, plasma concentration of endotoxin was determined with the modified chromogenic limulus assay. Results The number of bacteriodes and bifidobacterium in chronic severe hepatitis group was significantly decreased compared with that of control group and chronic hepatitis group (bacteriodes: 9.99 ± 0.45 ,10.51±0.39,10.39±0.38, P 0.001, P 0.01, respectively; bifidobacterium: 7.45 ± 2.00 , 9.62 ± 0.88 , 8.62±1.07, P 0.001, P 0.05 respectively). However, The number of fecal enterobacteriaceae and yeasts in chronic severe hepatitis group was significantly increased compared with that of control group and chronic hepatitis group (enterobacteriaceae: 9.00±0.63,8.05±0.96,8.34±0.94, P 0.001, P 0.05 respectively;yeasts: 4.96±1.81,3.32±0.97,3.63±0.94, P 0.01, P 0.05, respectively ).The number of fecal enterococcus of chronic severe hepatitis was significantly increased compared with that of control group ( P 0.001). The level of endotoxin in the chronic severe hepatitis group was significantly increased compared with that of the other groups (75.74±37.49ng/L,26.55±11.12ng/L,40.87±16.51ng/L, P 0.001,respectively). Analysis of the relationship revealed that the level of endotoxin was positively correlated with the number of fecal enterobacteriaceae ( P 0.05), and inversely correlated with that of fecal bifidobacterium ( P 0.001).Conclusion The data suggest that there are intestinal micro dysbiosis and overgrowth of aerobic gram negative bacillus in patients with chronic severe hepatitis, which might play an important role in the development of endotoxemia.