胆汁中内毒素的变化对肝损害影响的探讨

Investigation on influences of the changes of endotoxin in the bile on hepatic injury

探讨胆管炎患者肝损害与胆汁中内毒素的相关关系。51例胆总管远端结石患者按有无发展成急性胆管炎分为急诊手术组(n=25)和病情稳定的择期手术组(n=26)。术前抽空腹血,检测血浆ALT、AST、TBil的浓度;术中抽取胆汁,检测胆汁中内毒素、内皮素(ET-1)和降钙素基因相关肽(CGRP)的浓度。急诊手术组胆汁中内毒素、ET-1、CGRP含量和血浆ALT、AST、TBil的含量明显高于择期手术组。胆道感染时,内毒素不仅直接影响肝损害,而且内毒素对肝脏系统合成和释放ET-1、CGRP有强烈刺激作用,胆汁中ET-1和CGRP不平衡在胆管炎患者肝脏损害过程中起重要作用。

To investigate the relationship between the severity of liver injury in patients with bile bacterial infection and the endotoxin in the bile. According to clinical symptoms and signs, 51 patients with bile duet stone were divided into two groups, the selective operation group （ n = 26） and emergency operation group （ n = 25 ）. The levels of endotoxin, endtheline - 1 （ ET - 1 ） , and ealeitonin gene related peptide （CGRP） in the blood were determined during the operation and those of ALT, AST and TBil in the blood were mersured before the operation group. When bile is infected in the patients with bile duct stone, endotoxin can not only directly influeenee hepatic injury but also strongly stimulate the hepatobiliary system to synthesize and release ET - 1 and CGRP. And imbalance of ET - 1 and CGRP possibly plays important role in hepatic injury.