摘要
目的：观察乳果糖治疗对急、慢性肝病患者血清内毒素、细胞因子水平及肝功能指标的影响。方法：在８９例急、慢 性肝炎、肝硬化患者中，４９例口服乳果糖２０日，检测两次血清内毒素、细胞因子、胆红素及转氨酶。结果：治疗前，３组 患者血清内毒素水平有差异，肝硬化患者最高（６９．３ｐｇ／ｍｌ± ２３．６ｐｇ／ｍｌ），慢性肝炎患者最低 （２．４ｐｇ／ｍｌ± ７．９ｐｇ／ｍｌ），内毒素与ＴＮＦ－α（ｒ＝０．５５５，Ｐ＜０．０１）、ＩＬ－６（ｒ＝０．５３１，Ｐ＜０．０１）、ＩＬ－８（ｒ＝０．４４０，Ｐ＜０．０５）、Ｇ－ＣＳＦ（ｒ＝０.４４ ０，Ｐ＜０．０５）呈正相关，口服乳果糖组血清内毒素，ＴＮＦ－α、ＩＬ－６、ＩＬ－８和Ｇ－ＣＳＦ水平下降及肝功能改善较未服药者明 显。结论：急、慢性肝病时内毒素可能是ＴＮＦ－α、ＩＬ－６、ＩＬ－８和Ｇ－ＣＳＦ的诱导物，其共同参与肝脏炎症反应。口服乳果糖 可能通过降低血清内毒素、细胞因子水平而对肝病患者有利。
Background/Aims: To evaluate the effect of lactulose on serum levels of endotoxin and cytokines in patients with liver disease. Methods: Detecting serum levels of endotoxin and cytokines twice during a 20 days interval in 89 patients with acute hepatitis, chronic hepatitis and liver cirrhosis, among them, 49 administered lactulose orally. Results: Serum levels of endotoxin was highest in patients with cirrhosis (69. 3p g/ml ±2 3. 6pg/ml) and lowest in chronic hepatitis (28. 4pg /ml ±7. 9pg /ml); serum levels of endotoxin were positively correlated with those of TNF-a(r=0.555, P<0.01), IL-6(r=0.531, P<0.01), IL-8(r=0.440, P<0.05) and G-CSF (r=0.440, P<0.05), but not with IL-2 (r=-0.101, P>0.05); decreases of endotoxin and cytokines were more significant in patients taking lactulose than control group which was accompanied by decreases of ALT, AST and TB. Conclusions: Endotoxin could induce releases of total bitirubin some cytokines that participate in inflammation in patients with liver disease. Orally taking lactulose could decrease serum levels of endotoxin, thus exerting beneficial effect in those patients.
出处
《胃肠病学》
1999年第2期97-99,共3页
Chinese Journal of Gastroenterology
