肝硬化患者血清二胺氧化酶和内毒素检测及临床意义

Determination of serum diamine oxidase and endotoxin in cirrhosis patients and its clinical significance

目的:探讨肝硬化患者血清二胺氧化酶(diamine oxidase,DAO)和内毒素(endotoxin,ETX)水平的变化及临床意义。方法:52例肝硬化患者(肝硬化组),采用分光光度法和鲎试剂偶氮显色基质法检测治疗前、后外周血清中DAO和ETX水平,选择同期15名健康体检者作为对照组,并进行比较。结果:肝硬化组治疗前DAO水平高于对照组(P<0.01)。肝硬化组Child-pugh A级与B级患者治疗前ETX水平比较差异无统计学意义(P>0.05),余各分级间DAO,ETX水平差异均有统计学意义(P<0.01);治疗后C级患者DAO水平升高(P<0.05),余各分级DAO,ETX水平均明显降低(P<0.01)。合并腹腔积液患者DAO和ETX水平明显高于无腹腔积液患者(P<0.01);肝硬化患者DAO与ETX水平呈正相关(r=0.28,P<0.05)。结论:DAO可作为判断肠黏膜损伤的一项较敏感指标;肝硬化患者肠黏膜通透性升高,可能是导致内毒素血症发生的因素之一,且与肝硬化病情轻重有关。

Objective To study the changes of diamine oxidase and endotoxin activities in cirrhosis patients and its clinical significance.Methods The serum levels of diamine oxidase and endotoxin in 52 cirrhosis patients（cirrhosis group） were detected before and after treatment with spectrophotometry,and another 15 healthy volunteers were as controls.Results The level of diamine oxidase in cirrhosis group was significantly higher than that in control group before treatment（P0.01）.There was no significant difference in endotoxin between Child-pugh A and B before treatment（P0.05）,while the levels of diamine oxidase and endotoxin had significant differences between any other two Child-pugh degrees（P0.01）.The level of diamine oxidase increased in Child-pugh C（P0.05）,while the levels of diamine oxidase and endotoxin decreased in the other degrees（P0.01） after treatment.The patients with ascites had higher levels of diamine oxidase and endotoxin than those without ascites（P0.01）.The serum level of diamine oxidase was positively correlated with the level of endotoxin（r=0.28,P0.05） in patients with cirrhosis.Conclusion Diamine oxidase is a sensitive marker reflecting intestinal mucous impairment.The intestinal permeability increases in patients with cirrhosis,which may be one of the factors leading to endotoxemia.The changes of intestinal permeability may be correlated with the severity of cirrhosis.