Relationship between small intestinal bacterial overgrowth and severity of with hepatitis B cirrhosis / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the relationship between small intestinal bacterial overgrowth (SIBO) and the severity of hepatitis B cirrhosis. MethodsForty-seven patients with hepatitis B cirrhosis who visited Department of Gastroenterology, Zhengzhou People′s Hospital, from June 2014 to June 2015 were selected as cirrhosis group; these patients consisted of 11 Child-Pugh class A cases, 16 Child-Pugh class B cases, and 20 Child-Pugh class C cases. Fifteen healthy volunteers were selected as control group. The levels of procalcitonin, bilirubin, plasma albumin, and globulin were measured in all subjects. The lactulose hydrogen breath test (LHBT) was performed to measure small intestinal bacterial growth. Comparison of categorical data was made by chi-square test or Fisher's exact test. Comparison of normally distributed continuacs data between groups was performed by t test, The correlations of SIBO with procalcitonin, bilirubin, plasma albumin, and albumin/globulin ratio were investigated by Pearson correlation analysis. ResultsSIBO was found in 22 (46.8%) of the 47 patients with liver cirrhosis, consisting of 2 (18.1%) in the 11 Child-Pugh class A cases, 7 (43.7%) in the 16 Child-Pugh class B cases, and 13 (65.0%) in the 20 Child-Pugh class C cases. The prevalence of SIBO showed a significant difference between the controls and all patients with hepatitis B cirrhosis, Child-Pugh class B cases, or Child-Pugh class C cases (P=0.005, 0.037, or 0.001), but no significant difference between the controls and Child-Pugh class A cases (P=0556); there was a significant difference in the prevalence of SIBO between Child-Pugh class A cases and Child-Pugh class B/C cases (χ2=4727,P=0.030). The levels of procalcitonin, bilirubin, plasma albumin, and globulin were significantly correlated with LHBT set-value (r=0.895, 0.907, -0.810, and 0.755, respectively, all P＜0.001). ConclusionThe prevalence of SIBO increases with exacerbation of liver injury in patients with hepatitis B cirrhosis. The levels of procalcitonin, bilirubin, and globulin are positively correlated with SIBO, while plasma albumin level is negatively correlated with SIBO.