慢性乙型肝炎肝脏病理组织学改变与内毒素血症的关系

The Relationship betweem Serum Endotoxin and Hepatic Pathology in Patients with Chronic Hepatitis B

目的探讨慢性乙型肝炎患者血清内毒素、肝纤维化标志物水平与肝脏病理组织学改变的关系。方法选择112例慢性乙型肝炎患者和56例正常健康体检者，同时检测其血清内毒素（ET）及肝纤维化标志物（HA、LN、IVC和PⅢNP）水平，对所有慢性乙型肝炎患者行肝穿刺活检判断其病理组织炎症活动度分级和纤维化分期，并把血清内毒素及肝纤维化标志物水平与肝活检病理分级分期进行相关性分析。结果慢性乙型肝炎患者内毒素血症（ETM）的发生率随肝脏病变的加重而升高。血清内毒素、肝纤维化标志物水平与肝活检病理分级分期呈明显正相关。结论血清内毒素水平与肝纤维化血清标志物可作为肝脏病理损害的判断指标之一，内毒素血症在肝纤维化发生发展中起重要作用。

Objective To study the relationship between serum endotoxin level, serum hepatic fibrosis indexes and hepatic pathology in chronic hepatitis B. Methods The blood samples of following were collected： 112 chronic hepatitis B patients and 56 healthy persons. Endotoxin was detected by kinetic turbidimetric assay, hepatic fibrosis indexes （HA, LN, IVC and PⅢNP） were detected by using radioimmunoassay. Hepatic biopsy was performed on all the 112 patients to determine the inflammation grade and fibrosis staging. Results There was a positive correlation between serum endotoxin level, serum hepatic fibrosis indexes and hepatic pathological grade and staging in chronic hepatitis B. Coaclusioa Serum endotoxin level and serum hepatic fibrosis indexes can be used as one of the indexes to evaluate hepatic pathological damage. Bndotoxemia plays an important role in the course of hepatic fibrosis happening and development.