摘要
目的探讨肝炎肝硬化患者肠壁通透性与细菌及其毒素移位的关系。方法选择乙型肝炎肝硬化患者57例和16例健康志愿者,其中肝硬化患者按Child-Pugh分级分成A级14例,B级15例,C级28例。用高效液相色谱法(HPLC)测定各组尿中乳果糖和甘露醇(L/M)比值,同时采用鲎试验检测血浆内毒素,比较各组以及合并自发性细菌性腹膜炎(SBP)患者两指标改变情况。结果肝硬化各组内毒素水平均较正常对照组显著升高(P<0.05),而L/M值仅在肝硬化C级组显著升高(P<0.01),合并SBP肝硬化患者较未合并SBP肝硬化患者L/M值显著升高(P<0.01)。结论严重肝硬化和合并腹腔感染的肝硬化患者肠壁通透性升高,是产生肠源性感染的重要机制。
[Objective] To study the relationship between intestinal permeability and bacterial translocation in patients with post-hepatitis hepatic cirrhosis. [Methods] Fifty-seven patients with post-hepatitis B cirrhosis were studied, meanwhile, 16 healthy subjects were enrolled as control. All patients were devided into Child-Pugh A 14 cases, Child-Pugh B 15 cases, Child-Pugh C 28 cases according to Child-Pugh classifity. The lactulose （L） and mannitol （M） concentration in all subjects urine was analyzed by HPLC. RI, the L/M ratio was calculated, plasma endotoxin in cirrhotics and control group was measured with limilus lysate test. [Results] Plasma endotoxin in three cirrhotics groups was significantly higher than in control group （P 〈0.05）, L/M ratio only in Child-Pugh C cases was significantly higher than in control group （P 〈0.01）, L/M ratio in cirrhotics with spontaneous bacterial peritonitis （SBP） was significantly higher than in cirrhotics without SBP （P 〈0.01）. [Conclusion] Intestinal permeability was increased in cirrhotic patients with severe hepatic cirrhosis and in those with bacterial infections, and it contributed to enterogenic infection in patients with hepatic cirrhosis.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2008年第10期1438-1440,共3页
China Journal of Modern Medicine
关键词
肝硬化
肠壁通透性
肠源性感染
细菌移位
hepatic cirrhosis
intestinal permeability
enterogenic infection
bacterial translocation
