Abstract: Objective The purpose of this study was to observe the manifestations of small intestinal mucosal lesions in patients with chronic hepatitis B(CHB) and to explore the relationship between small intestinal mucosal lesions and clinical data, biochemical indexes and hepatic fibrosis indexes.Methods 158 patients with CHB were recruited in this study between January 2015 and December 2019, and all of them underwent capsule endoscopy. The intestinal mucosal manifestations were evaluated by Lewis score system. The typical mucosal abnormalities were chorionic edema, increased fragility, necrotizing erosion, mucosal ulcer, mucosal edema with erosion and inflammatory stenosis.Results Out the 158 patients with CHB, 94 patients (59.5%)had normal, and 64 patients (40.5%) had abnormal bowel mucosa; the incidence of bile reflux in patients with abnormal bowel mucosa was 62.5%, significantly higher than 35.1% in those with normal bowel mucosa (P<0.05); the Lewis score in patients with abnormal bowel mucosa was (140.6±80.2), significantly higher than that in patients with normal bowel mucosa 【(0.0±0.0), P<0.05); blood platelet count, serum ALT, AST, GGT, albumin, bilirubin, creatinine, and urea levels in in patients with abnormal bowel mucosa were(208.6±65.2)×10⁹/L, (32.5±10.6)U/L, (35.0±7.8)U/L, (47.9±12.5)U/L, (39.2±4.4)g/L, (18.8±15.2)μmol/L, (89.6±16.8)μmol/L and (6.6±2.7)mmol/L, all significantly different compared to 【(248.2±72.6)×10⁹/L, (16.2±8.2)U/L, (15.8±8.6)U/L, (18.2±14.2)U/L, (43.6±5.2)g/L, (12.7±4.8)μmol/L, (80.4±15.6)μmol/L and (5.2±1.4)mmol/L, respectively, P<0.05】 in patients with normal bowel mucosa, while they were no significant differences with respect to age, gender, smoking alcohol consumption, serum HBV DNA loads, and prothrombin times between the two groups (P>0.05); the APRI, Forns index, S index, FIB-4 and BARD score in patients with abnormal bowel mucosa were (0.35±0.42), (7.52±1.51), (0.08±0.13), (1.80±1.31) and (2.11±0.71), significantly different compared to 【(0.22±0.14), (6.40±1.42), (0.05±0.06), (1.20±0.61) and (1.83±0.72), respectively, P<0.05】 in those with normal bowel mucosa.Conclusion There are some kind of different degrees of intestinal mucosal abnormalities in patients with CHB, and the pathological changes might be related to some extent to the liver function injuries, and warrants further investigation.

Key words: Hepatitis B, Capsule endoscopy, Small intestinal mucosa, Lewis scoring system