肝硬变血浆内毒素与一氧化氮水平的改变及关系的研究

• 作 者: 任锡玲 姚希贤
• 机 构: 解放军２７１医院消化科,河北医科大学第二医院内科
• 出 处: 新消化病学杂志
• 发表日期: 1997年06期
• 关键词: 血浆内毒素 一氧化氮水平 腹水患者 内毒素检测 内毒素／血液 一氧化氮／血液 鲎试剂 枯否细胞 肝毒性物质 内毒素血症

目的研究肝硬变患者血浆内毒素与一氧化氮水平改变及关系．方法应用鲎试剂定量法和高效液相色谱分析法分别检测肝硬变患者４４例（男３２例，女１２例；年龄２５岁～７３岁，平均５０４岁±１１０岁）；ＣｈｉｌｄＰｕｇｈＡ级９例，Ｂ级２０例，Ｃ级１５例；其中有腹水者２７例及健康对照２５例（男１８例，女７例，年龄２４岁～６３岁，平均４６８岁±１２４岁）血浆内毒素和一氧化氮水平．结果肝硬变血浆内毒素及一氧化氮水平（２３７１ＥＵ／Ｌ±８２３ＥＵ／Ｌ，３８７１７ｎｇ／ｍｌ±１０６４１ｎｇ／ｍｌ）明显高于对照组（１５６７ＥＵ／Ｌ±２４６ＥＵ／Ｌ，２９２３０ｎｇ／ｍｌ±５４４９ｎｇ／ｍｌ，Ｐ＜００１）．腹水患者内毒素与一氧化氮水平（２３６９ＥＵ／Ｌ±５３６ＥＵ／Ｌ，４１４６７ｎｇ／ｍｌ±１０７０５ｎｇ／ｍｌ）明显高于无腹水者（１９６９ＥＵ／Ｌ±４５２ＥＵ／Ｌ，３２７１７ｎｇ／ｍｌ±７０２０ｎｇ／ｍｌ，Ｐ＜００５，Ｐ＜００１）．一氧化氮与内毒素呈直线正相关（Ｐ＜００１，ｒ＝０７８２）．结论肝硬变患者血浆内毒素及一氧化氮水平皆升高，且两者呈直线正相关．

Objective To study the changes of plasma endotoxin and nitric oxide levels in patients with cirrhosis. Methods Forty-four patients with liver cirrhosis (32 males and 12 females; aged from 25 to 73 years, with an average of 504 years ± 110 years of age) were enrolled in the study. PughA grade 9 cases, B grade 20 cases, C grade 15 cases; including ascites in 27 cases and 25 healthy controls (18 males and 7 females, aged 24 years to 63 years, mean 46.8 years ± 12  4 years old) plasma endotoxin and nitric oxide levels. Results The levels of plasma endotoxin and nitric oxide in patients with cirrhosis (2371EU / L ± 823EU / L, 38717ng / ml ± 10641ng / ml) were significantly higher than those in the control group (1567EU / L ± 24  6EU / L, 29230ng / ml ± 5449ng / ml, P <001). The levels of endotoxin and nitric oxide in patients with ascites (2369EU / L ± 536EU / L, 41467ng / ml ± 10705ng / ml) were significantly higher than those without ascites (1969EU / L ± 452EU / L, 3271.7ng / ml ± 7020ng / ml, P <005, P <001). Nitric oxide was positively correlated with endotoxin (P <001, r = 0782). Conclusions Plasma endotoxin and nitric oxide levels are elevated in patients with cirrhosis, and there is a linear positive correlation between them.