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目的 了解内毒素与细胞因子之间的关系,以澄清造成肝病的细胞因子变化的可能原因。方法 应用鲎试剂三肽基质显色法,对89例急慢性肝病患者血清进行内毒素检测,所有患者根据是否口服乳果糖分为2组,并观察治疗前后内毒素浓度及细胞因子水平。结果 肝硬化内毒素水平为(69.3±23.6)pg/ml,高于急性肝炎的(44.6±14.3)pg/ml及慢性肝炎的(28.4±7.9)pg/ml内毒素浓度,与TNFα、IL6、IL8及GCSF呈正相关,它们相关系数分别为r=0.555、0.531、0.44及0.44,统计学有意义,但于IL2无关(r=0.101),口服乳果糖治疗20天后,血清内毒素及细胞因子平行下降。结论 血清内毒素与细胞因子呈正相关,肝病时内毒素可能在致细胞因子变化中起主要作用。口服乳果糖可降低细胞因子及内毒素,因而对肝病有益。
Objective To understand the relationship between endotoxin and cytokines in order to clarify the possible causes of cytokine changes that cause liver disease. Methods Serum endotoxin was detected in 89 patients with acute and chronic liver disease by using the reagent tri-peptide substrate colorimetric method. All patients were divided into 2 groups according to whether oral administration of lactulose, and the endotoxin concentrations and cytokines levels were observed before and after treatment. Results The level of endotoxin in liver cirrhosis was (69.3 ± 23.6) pg / ml, higher than that in acute hepatitis (44.6 ± 14.3) pg / ml and chronic hepatitis (28.4 ± 7.9) pg / IL8 and GCSF were positively correlated with the correlation coefficient of r = 0.555,0.531,0.44 and 0.44 respectively, with statistical significance, but not with IL2 (r = 0.101). After oral administration of lactulose for 20 days, serum endotoxin and cytokines were parallel decline. Conclusions Serum endotoxin is positively correlated with cytokines. Endotoxin may play a major role in the changes of cytokines in liver diseases. Oral lactulose can reduce cytokines and endotoxin, which is beneficial to liver disease.