肝硬化大鼠门静脉内毒素水平与Child-Pugh分级之间的关系

Association between portal endotoxemia and Child-Pugh classification in complex pathogens-induced hepatic cirrhosis in rats

目的:研究CCl4诱导大鼠肝硬化形成过程中门静脉内毒素与Child-Pugh分级,探讨肠道在大鼠肠源性内毒素及大鼠肝硬化代偿向失代偿转化中的作用．方法:20只Wistar大鼠采用CCl4复合因素诱发大鼠肝硬化模型,6只作为对照．于制模开始后的6及10 wk分别测定凝血酶原时间,白蛋白, 胆红素,腹水情况,脑电图情况及门静脉内毒素水平,并依据Child-Pugh分级系统确定大鼠肝功能分级．比较Child分级与门静脉内毒素的关系．结果:经Spearman等级相关分析,Child-Pugh 分级指标与白蛋白、凝血酶原时间显著相关 (r=-0．695,P<0．05;r=0．649,P<0．05),而与胆红素没有显著相关性(r=0．111,P=0．732)．门静脉内毒素水平随着肝硬化模型制作时间的延长而逐渐加重,正常大鼠门静脉内毒素水平与6及10 wk毒素门静脉内毒素水平比较均有统计学差异(925．1±527．7 mEU/L vs 1983．7± 586．4,2600．74±343．8 mEU／L,均P<0．01),门静脉内毒素水平与时间相关(r=0．624,P<0．01), 与Child-Pugh分级之间有显著相关(r=0．680, P<0．01)．结论:肝硬化大鼠门静脉高内毒素血症与肝功能分级有显著相关关系,说明肠源性内毒素在大鼠肝硬化代偿向失代偿转化中起着重要作用．

AIM： To evaluate the association between the Child-Pugh classification and portal endotoxemia during the course of rat liver cirrhosis induced by carbon tetrachloride （CC14） plus ethanol and cholesterol. METHODS： Liver cirrhosis model was induced in 20 Wistar rats using CC14 plus ethanol and cholesterol, while 6 rats were treated as controls. At 6 and 10 wk, serum samples were collected from portal vein for the detection of prothrombin time, albumin, bilirubin and endotoxin level and the ascites and brain wave were also tested. The liver function was evaluated by Child-Pugh scoring system and the relationship between Child-Pugh classification and portal endotoxemia was assessed. RESULTS： Spearman rank correlation analysis showed that Child-Pugh grading was correlated with albumin level and prothrombin time （r = -0.695, P 〈 0,05; r = 0.649, P 〈 0.05）, but not with bilirubin level （P 〉 0.05）. The level of endotoxin in portal vein was elevated with prolonging of cirrhosis time, and it was significantly higher at 6 or 10 wk than that in the controls （1983.7 ± 586.4, 2600.7 ± 343.8 mEU/L vs 925.1 ± 527.7 mEU/L, both P 〈 0.01）. Endotoxin level was correlated with cirrhosis time （r = 0.624, P 〈 0.01） and Chfld-Pugh classification （r = 0.680, P 〈 0.01）. CONCLUSION： Portal endotoxemia is significantly correlated with Child-Pugh classification, indicating that intestinal endotoxemia plays an important role during the course of complex pathogens-induced cirrhosis in rats.