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[目的]探讨乙型肝炎后肝硬化患者的小肠细菌过度生长(SIBO)情况,以及SIBO与其肝功能状况、HBV-DNA之间的关系。[方法]将42例乙型肝炎后肝硬化患者按肝功能Child-Pugh分级分为A级、B级、C级三组,并入选同期门诊体检的健康者20例作为健康对照组。通过葡萄糖氢呼气试验(GHBT)检测并比较分析各组SIBO情况,同时检测并比较分析肝硬化患者各组的HBV-DNA水平及其SIBO阳性率。[结果]肝硬化各组患者与健康对照组的SIBO阳性率及试餐后呼气氢浓度比较均差异有统计学意义(P<0.05)。肝硬化患者的SIBO阳性率及试餐后呼气氢浓度均随着Child-Pugh分级低下而呈渐进性增高,各组间差异有统计学意义(P<0.05)。肝硬化患者各组间的SIBO阳性率及试餐后呼气氢浓度比较,HBV-DNA>10~3时均明显高于HBV-DNA≤10~3时,且差异有统计学意义(P<0.05)。[结论]乙型肝炎后肝硬化患者常存在SIBO,且随着肝功能恶化、HBV-DNA拷贝数增加,其SIBO加重,由此推测防治SIBO,可能对乙型肝炎后肝硬化患者的肝功能改善、乙肝病毒清除有益。
[Objective] To investigate the intestinal bacterial overgrowth (SIBO) in patients with posthepatitic cirrhosis and the relationship between SIBO and its liver function and HBV-DNA. [Methods] Totally 42 patients with hepatitis B cirrhosis were divided into A, B and C groups according to the Child-Pugh classification of liver function. 20 healthy subjects were selected as the healthy control group. The levels of SIBO and the levels of SIBO in HBV-DNA of each group were detected and compared by the GHBT test and the comparative analysis of SIBO in each group. [Results] The positive rates of SIBO in patients with cirrhosis and healthy controls were significantly lower than those in healthy controls (P <0.05). The positive rate of SIBO in patients with cirrhosis and the expired hydrogen concentration after test meal gradually increased with the Child-Pugh low grade, and the difference was statistically significant (P <0.05). The positive rate of SIBO and the concentration of exhaled hydrogen after the meal in patients with cirrhosis were significantly higher than those with HBV-DNA> 10 ~ 3 when HBV-DNA was less than or equal to 10 ~ 3, and the difference was statistically significant (P < 0.05). [Conclusion] SIBO often exists in patients with posthepatitic cirrhosis, and with the worsening of liver function, HBV-DNA copy number increases and its SIBO aggravates. Therefore, presumed that the prevention and treatment of SIBO may affect the liver function of patients with posthepatitic cirrhosis Improvement, hepatitis B virus removal beneficial.