梗阻性黄疸病人内毒素血症与肾功能的初步测定

EASUREMENT OF ENDOTOXEMIA AND RENAL FUNCTON IN PATIENTS WITH OBSTRUCTIVE JAUNDICE

为探讨梗阻性黄疸病人内毒素血症的发生情况以及内毒素血症与肾功能之间的关系。作者对１１例梗阻性黄疸病人和１０例无黄疸病人进行术前术后内毒素和内生肌酐清除率的测定，上述病例临床上均无感染征象。梗阻性黄疽病人６４％有内毒素血症，而对照组病人均无，两组比较差异有极显著性（Ｐ＜０．００５）。内毒素血症与病人术前硷性磷酸酶的升高水平以及术前肌酐清除率下降有联系（Ｐ＜０．０５）。４５％的梗阻性黄疸病人术前肌酐清除率下降，他们均伴有内毒素血症，并且肌酐清除率下降与术前碱性磷酸酶的升高水平有关（Ｐ＜０．０５）。本文结果提示：梗阻性黄疽病人常伴有内毒素血症与肾功能损害，内毒素血症可能是肾功能损害的重要原因。

clinical control trial was undertaken to observed the incidence of endotoxemia and therelationship between endotoxemia and renal function in patients with obstructive jaundice.11obstructive jaundiced patients and 10 non-jaundiced patients were measured for endotoxinand endogenous creatinine clearance before and after operation,Sixty-four percent of jaun-diced patients were found to have perioperative endotoxemia,no patients in control grouphad endotoxemia,The incidence of endotoxemia in jaundiced patients was very significantlygreater than in non-jaundiced patients(P<0.005).Endotoxemia was associated with preo-prative increased AKP level and preoperative decrease in creatinine clearance(P<0.05).Forty five percent of jaundiced patients had preoperative decrease in creatinine clearance,allof them were accompanied by endotoxemia,and the decrease in creatinine clearance was as-sociated witb preoperative increased AKP level(P<0.05).The results of this study indi-cated that endotoxemia and renal dysfunction in patients with obstructive jaundice are com-mon and the endotoxemia may be an important pathogenic factor in renal impairment.