慢性肝病患者血清内毒素定量检测及丽珠肠乐对其影响

Determination of the serum endotoxin level and effect of bifidobiogen in patients with chronic liver diseases

目的 探讨慢性肝病患者内毒素血症 (Endotoxemia,ETM )的发生率及临床意义 ,并观察丽珠肠乐治疗肝病合并ETM的转阴率。方法 应用偶氮基质显色法鲎试验方法检测 110例慢性肝病患者血清内毒素 (ET)水平 ,并选择 80例慢性肝病合并ETM患者 ,随机分丽珠肠乐治疗组 (n =4 0 )和对照组 (n =4 0 )。结果 慢性肝病患者血清ET水平明显高于正常对照组 ,以重症肝炎最高。重症肝炎组血清胆红素>342 μmol/L、白蛋白 <30g/L及PT活动度 <30 %时ETM发生率为 10 0 % ,ET水平高于血清胆红素 (171μmol/L <TB<342 μmol/L)、白蛋白 >30 g/L及PT活动度 >30 %的患者。慢性肝病腹水患者腹水与血清ET水平均升高 ,分别为(315± 80 )与 (342± 83)ng/L。服丽珠肠乐治疗后 ,慢性肝病合并ETM组的转阴率较对照组为高。结论 慢性肝病患者ETM发生率高 ,肠道微生态调节剂丽珠肠乐能有效地减轻或清除ETM。

Objective To determine the serum endotoxin level and investigate the effect of bifidobiogen on thechange of endotoxin in patients with chronic liver diseases. Methods The serum endotoxin level was measured by using limulus polyphemus test with modified chromogenic method in 110 patients with chronic liver diseases. 80 patients with endotoxemia were randomly divided into two groups: bifidobiogen group( n =40) and the control group( n =40). Results The serum endotoxin level in patients with chronic liver diseases was significantly higher than those of healthy controls( P <0.01), the highest level was found in the patients with chronic severe hepatitis. The serum endotoxin level was markedly higher in total bilirubin>342 μmol/L; albumin<30 g/L; and thrombinogen activity<30% than in total bilirubin(171 μmol/L<TB<342 μmol/L); albumin>30 g/L; and thrombinogen activity>30% in patients with chronic severe hepatitis. The ascite and serum endotoxin levels were significantly elevated in patients with chronic hepatitis combined with ascite, which were (315±80) and (342±83) ng/L,respectively. The efficacy in bifidobiogen group was significantly higher than that in control group. Conclusion Chronic liver diseases are generally complicated with endotoxemia, the serum endotoxin level may be reduced after the treatment with bifidobiogen.