Influence of Intestinal Bacterial Overgrowth on Disease Progression in Patients with Hepatitis B Cirrhosis
ZHANG Yilan
MA Yingjie
GUO Yunxia
BAI Lu
HAN Li
Abstract：Objective To investigate the effect of small intestinal bacterial overgrowth(SIBO)on the progression of liver cirrhosis in patients with hepatitis B(hepatitis B).Methods This study was a retrospective analysis study.The data of 149 patients with hepatitis B cirrhosis admitted to People's Hospital of Zhengzhou from January 2019 to December 2023 were collected.According to the situation of SIBO at admission,they were divided into the combined SIBO group and non-combined SIBO group.The clinical data of the two groups were compared.Furthermore,based on whether the patient developed acute-on-chronic liver failure(ACLF)during the 6-month follow-up period,the disease progression was evaluated and divided into a disease progression group and a disease non progression group.The disease progression of patients with and without SIBO was compared,and the data of patients in the disease progression group and the disease non progression group were compared.The influence of SIBO and other main variables on the disease progression of patients with hepatitis B cirrhosis,and the predictive value of SIBO and other main variables on the disease progression of patients with hepatitis B cirrhosis were analyzed.Results Among the 149 patients,52 were combined with SIBO.The proportion of Child-Pugh grade C at admission in the combined SIBO group was higher than that in the non-combined SIBO group.The levels of white blood cells,total bilirubin,alanine aminotransferase(ALT),international normalized ratio(INR)and prothrombin activity(PTA)at admission were higher than those in the non-combined SIBO group.The levels of albumin and prealbumin at admission were lower than those in the non-combined SIBO group,with statistical significant differences(P＜0.05).During the 6-month follow-up period of 149 patients,28 cases developed ACLF(disease progression),accounting for 18.79％.The incidence of disease progression in the combined SIBO group was higher than that in the non-combined SIBO group,with statistical significant differences(P＜0.05).At admission,the proportion of children with Child-Pugh grade C in the disease progression group was higher than that in the disease non progression group.At admission,the levels of white blood cells,total bilirubin,ALT,INR,and PTA were higher than those in the disease non progression group.At admission,the levels of albumin and prealbumin were lower than those in the disease non progression group,with statistical significant differences(P＜0.05).Logistic regression analysis showed that low albumin level and SIBO were independent risk factors for disease progression in patients with hepatitis B cirrhosis(P＜0.05).The nomogram model was drawn,and the results showed that the C-index of combining SIBO with other main variables to predict the risk of disease progression in patients with hepatitis B cirrhosis was 0.779(95％CI:0.692-0.866),which suggested that the model had certain predictive efficacy.Conclusion The combination of SIBO has a certain impact on the disease progression of patients with hepatitis B cirrhosis,which may increase the risk of disease progression in the short term.
Keywords：hepatitis Bcirrhosisdisease progressionsmall intestinal bacterial overgrowth
Publication Date：2026-02-28
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：6( 636-641 )