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目的分析肝性脑病患者肠道菌群的变化情况,为临床肝性脑病的诊治提供参考和借鉴。方法从笔者医院2012年3月~2014年3月收治的80例乙型肝炎肝硬化患者中筛选出38例肝性脑病患者及42例肝硬化非肝性脑病患者,另选取40例同期在笔者医院体检的健康者作为健康对照组,对3组受试者肠道菌群进行比较和分析。结果肝性脑病组患者乳杆菌属及肠球菌属菌落数均显著低于非肝性脑病组及健康对照组,酵母样真菌属菌落数显著多于非肝性脑病组及健康对照组,差异均有统计学意义(P<0.05)。非肝性脑病组患者菌群菌落数酵母样真菌属与健康对照组相比,差异无统计学意义(P>0.05),乳杆菌属及肠球菌属均显著少于健康对照组(P<0.05)。肝性脑病组患者双歧杆菌显著少于非肝性脑病组患者及健康对照组,大肠杆菌显著多于非肝性脑病组患者及健康对照组,差异有统计学意义(P<0.05)。非肝性脑病组与健康对照组相比,差异无统计学意义(P>0.05)。结论肝性脑病的患者存在肠道菌群失调,其可能是引起肝性脑病的重要因素,调节肠道菌群,保持肠道微生态平衡是治疗肝性脑病的重要策略。
Objective To analyze the changes of intestinal microflora in patients with hepatic encephalopathy and provide references for the diagnosis and treatment of clinical hepatic encephalopathy. Methods 38 patients with hepatic encephalopathy and 42 patients with non-hepatic encephalopathy were screened from 80 patients with hepatitis B cirrhosis admitted from March 2012 to March 2014 in our hospital. Another 40 patients were selected during the same period Healthy people in the hospital as a healthy control group, the intestinal flora of three groups were compared and analyzed. Results The number of Lactobacillus and Enterococcus in patients with hepatic encephalopathy were significantly lower than those in non-hepatic encephalopathy and healthy controls, and the number of yeast-like fungi was more than that in non-hepatic encephalopathy and healthy controls There was statistical significance (P <0.05). There was no significant difference in the number of colony-count yeast-like fungi among non-hepatic encephalomyelitis group and healthy control group (P> 0.05), Lactobacillus and Enterococcus genus (P <0.05) ). Bifidobacterium in patients with hepatic encephalopathy was significantly less than that in non-hepatic encephalopathy patients and healthy controls, Escherichia coli was significantly more than non-hepatic encephalopathy patients and healthy controls, the difference was statistically significant (P <0.05). There was no significant difference between non-hepatic encephalopathy group and healthy control group (P> 0.05). Conclusions Hepatic encephalopathy patients have intestinal flora imbalance, which may be an important factor in causing hepatic encephalopathy. Regulating intestinal flora and keeping the intestinal microflora balance is an important strategy for the treatment of hepatic encephalopathy.