目的　了解慢性重型肝炎患者肠道菌群失调的程度及其与血内毒素的关系。方法　用光冈氏法定性定量分析肠道 8种细菌 ,以偶氮显色法定量测定血内毒素。结果　慢性重型肝炎组与对照组、慢性肝炎组相比较 ,类杆菌、双歧杆菌显著减少 ;而肠杆菌科细菌、酵母菌显著增加。慢性重型肝炎组血内毒素较对照组及慢性肝炎组均显著增加 (P <0 .0 0 1)。血内毒素水平与肠杆菌科细菌值呈正相关 (r =0 .2 2 8,P <0 .0 5 )。结论　慢性重型肝炎患者存在严重的肠道微生态失调及细菌过度生长 ,其血内毒素升高可能与之有关。 Objective To understand the degree of intestinal flora imbalance in patients with chronic severe hepatitis and its relationship with endotoxin. Methods Eight kinds of gut bacteria were qualitatively and quantitatively determined by Guang Gang’s method, and the blood endotoxin was quantitatively determined by azo-chromogenic method. Results Compared with the control group and the chronic hepatitis group, the number of Bacteroides and Bifidobacteria significantly decreased in the chronic severe hepatitis group, but the Enterobacteriaceae and yeast significantly increased. Chronic severe hepatitis group blood endotoxin than the control group and chronic hepatitis group were significantly increased (P <0.01). Blood endotoxin levels and Enterobacteriaceae bacteria was positively correlated (r = 0.228, P <0. 05). Conclusions There are serious gut microecosystem disorders and bacterial overgrowth in patients with chronic severe hepatitis, and the increase of blood endotoxin may be related to it.