内毒素血症与病毒性肝炎的关系  

Relationship between endotoxemia and viral hepatitis

作　　者：吴景迪[1] 巫善明[1] 徐晓敏[1] 史晓燕[1] 

机构地区：[1]复旦大学附属公共卫生中心,上海201508

出　　处：《世界感染杂志》2005年第5期381-383,共3页World Journal of Infection

摘　　要：目的 研究人体血内内毒素（ET）的水平与病毒性肝炎病情程度及预后的关系。方法 用鲎试剂来检测154例病毒性肝炎病人血清内毒素水平，根据血内毒素水平的高低分成三组：血内毒素正常组（〈10ng/mL），血内毒素轻度异常组（10-20ng/mL），血内毒素明显异常组（〉20ng/mL）。比较各组肝功能损害的程度、继发感染的发生率及预后情况。结果 病毒性肝炎血内毒素正常者，肝功能损害轻，没有继发感染发生，预后好；血内毒素轻度升高（10-20ng/mL）者，肝功能损害较重，可见有合并原发性细菌性腹膜炎（SBP）及肺部感染，严重感染少见，有16％的病人抢救无效死亡；血内毒素明显升高者（〉20ng/mL），肝功能损害严重，多见合并SBP、肺部感染、急性胰腺炎、感染性休克，预后差，有66．7％抢救无效死亡，三组比较有非常显著差异，P〈0．0l。结论 血内毒素水平直接与肝功能损害程度及预后成正向关，要加强血内毒素的检测及抗内毒素治疗。Objective To study the relationship between the serum level of endotoxin （ET） and the hepatic inflammatory degree, secondary infection. Methods the serum level of ET was detected by Limulus in 154 patients. According to the serum level of ET, all the patients were divided into serum level of ET normal group （〈10ng/mL）, slightly abnormal group （10-20ng/mL）, obviously abnormal group （〉20ng/mL）, and we analyzed the hepatic inflammatory degree, the rate of secondary infection and the prognosis in each group. Results In the serum level of ET normal group, the severity of liver inflammatory was slight, no patient had secondary infection; In slightly abnormal group, the hepatic inflammatory degree was severe, some patients complicated with SBP and pulmonary infection, seldom complicated with sever infection, the mortal was 16%; In obviously abnormal group, most patients complicated with SBP and pulmonary infection, some patients complicated with acute pancreatitis and septic shock, the mortal was 66.7%. Conclusions The serum level of ET paralleled the severity of liver inflammatory and prognosis; we should emphasize the detection of ET and anti-endotoxin therapy in clinic.

关 键 词：血内毒素 鲎试剂 原发性细菌性腹膜炎(SBP) 抗内毒素治疗 

分 类 号：R512.6[医药卫生—内科学]