Changes in intestinal microflora in patients with chronic severe hepatitis

Objective To investigate changes in intestinal microflora in patients with chronic severe hepatitis (CSH), and their role in this life-threatening dis ease. Methods We classified nineteen patients with chronic severe hepatitis as th e CSH group, thirty patients with chronic hepatitis (CH) as the CH group an d thirty-one healthy volunteer as the control group. Fecal flora from all s ubjects were analyzed. Concentrations of plasma endotoxin, serum cytokines tumor necrosis factor alpha (TNF-alpha) and interleukin-1 beta (IL-1 beta) and liver function were assessed. Results The number of fecal bifidobacterium ( P < 0.001, P < 0.05 respectiv ely), as well as bacteroidaceae ( P < 0.001, P < 0.01 respectively) were si gnificantly deceased in patients with chronic severe hepatitis compared wit h the CH and control groups, while the number of enterobacteriaceae ( P < 0 .001, P < 0.05 respectively) and yeasts ( P < 0.01, P < 0.05 respectively) were significantly increased. Levels of plasma endotoxin, serum TNF-alpha, IL-1 beta and total bilirubin (TBiL) were significantly increased in the CS H group. The concentration of endotoxin positively correlated with levels o f both TNF-alpha, IL-1 beta and TBiL ( P < 0.001, respectively). Levels of plasma endotoxin were positively correlated with the number of fecal entero bacteriaceae and negatively correlated with bifidobacterium ( P < 0.05, P < 0.001, respectively). Conclusion Intestinal flora in patients with chronic severe hepatitis were severely disturbed and gut mircobiological colonization resistance was impa ired. Changes in intestinal flora may have a pivotal role in both the eleva tion of plasma endotoxin and further hepatic lesions resulting in liver fai lure.