胆汁酸对肝硬化大鼠肠道细菌过度生长、细菌移位和内毒素血症的影响

Effects of bile acids on intestinal bacterial overgrowth, bacterial translocation,and endotoxemia in cirrhotic rats

目的观察胆汁酸对于肝硬化大鼠的小肠细菌过度生长、细菌移位和内毒素血症的影响。方法37只肝硬化大鼠及30只相似体重的健康大鼠,随机分为熊去氧胆酸组、甘氨胆酸组(均为70mg/kg·d)和安慰剂组治疗两周。测定胆汁分泌速度、回肠细菌总数、细菌移位和内毒素血症的发生率。结果给予安慰剂的肝硬化大鼠,胆汁分泌速度低于健康大鼠(P<0.001)。给予胆汁酸治疗后,胆汁分泌速度增至正常水平。肝硬化大鼠比健康大鼠的回肠细菌总量显著增高(P<0.001),而给予胆汁酸使其回肠细菌总量降至正常水平。给予胆汁酸的肝硬化大鼠细菌移位率和内毒素血症发生率均较给予安慰剂的肝硬化大鼠低(P<0.001),而存活率高于安慰剂组。结论给予肝硬化大鼠胆汁酸可以增加胆汁分泌,抑制肠道细菌过度生长,减少细菌移位和内毒素血症的发生率,提高存活率。服用胆汁酸可能有益于防治肝硬化肠源性细菌感染。

Objective To evaluate the effects of bile acid on intestinal bacterial overgrowth and the incidence of bacterial translocation and endotoxemia in cirrhotic rats.Methods 37 cirrhotic rats induced by CCl_4 were randomized to be treated with cholyglycine,ursodeoxycholic acid(both at 70 mg/kg·d),or placebo for 2 weeks.30 similar weight healthy rats as controls were treated similarty.At the end of treatment,the rate of bile secretion,total bacteria in Ileal,and the incidence of bacterial translocation and endotoxemia in cirrhotic rats and healty rats were measured.Results In cirrhotic rats reveiving placebo,bile secretion from an acute biliary fistula was lower than in healthy rats(P<0.001).Feeding bile acids to cirrhotic rats normalized bile secretion.Total ileal bacterial content was significantly higer in cirrhotic rats(P<0.01).Bile acid administraion reduced bacterial content to normal levels.Bacterial translocation was less in cirrhotic rats by bile acids feeding bile acids than in rats receiving placebo.Endotoxemia was decreased in cirrtotic rats receiving bile acids compared with placebo(P<0.001).Survival was greater in rats receiving bile acids.Conclusion Administration of bile acids to cirrhotic rats resulted in an increase of bile acid secretion,a reduction of intestinal bacterial overgrowth,bacterial transolcation,endotoxemia,and a raise of survival,which suggests that oral bile acids may be useful in preventing infection caused by intestinal bacterium in cirrhotic patients.