重度慢性乙型病毒性肝炎患者肠黏膜通透性的变化及其机制  

Alterations of intestinal permeability in chronic severe HBV-infected patients

作　　者：宋怀宇[1] 姜春华[2] 杨建荣[1] 陈秋虹 黄云花[1] 梁列新[1] 

机构地区：[1]广西壮族自治区人民医院,广西壮族自治区南宁市530000 [2]南宁市第四人民医院,广西壮族自治区南宁市530000 [3]广西测试中心,广西壮族自治区南宁市530000

出　　处：《世界华人消化杂志》2008年第31期3561-3565,共5页World Chinese Journal of Digestology

基　　金：广西科学基金资助项目;No.桂科回0639013~~

摘　　要：目的:研究重度慢性乙型病毒性肝炎患者肠黏膜通透性的变化并探讨其病理生理机制.方法:采用高效液相色谱蒸发光散射器(HPLC-ELSD)检测30例正常人和30例重度慢性乙型肝炎患者尿中乳果糖和甘露醇排泄率的变化,以尿乳果糖/甘露醇排泄率的比值(L/M)反映肠黏膜通透性的变化.结果:与正常人相比,重度慢性乙型肝炎患者尿乳果糖的排泄率增加(0.0860±0.0225 vs 0.0650±0.0270,P=0.002),尿甘露醇的排泄率无明显变化,而尿乳果糖/甘露醇排泄率的比值(L/M)明显升高(0.0430±0.0198 vs 0.0316±0.0134,P=0.011).结论:重度慢性乙型肝炎患者肠黏膜通透性增高,导致内毒素经肠道途径大量入血,引起内毒素血症,在重度慢性乙型肝炎发生,发展过程中发挥重要的病理生理作用.AIM： To investigate the changes of intestinal permeability in chronic severe HBV-infected patients. METHODS： Thirty chronic severe HBV-infected patients and 30 normal controls were measured for intestinal permeability in terms of lactulos/ mannitol ratio （L/M）, respectively. The urine levels of lactulos and mannitol were detected using high performance liquid chromatography with evaporative light scattering detector. RESULTS： Compared with normal controls, the urine level of lactulos was significantly raised in chronic severe HBV-infected patients （0.0860 ± 0.0225 vs 0.0650 ± 0.0270, P = 0.002）, while the urine level of mannitol was not affected. A significant rise in urinary L/M ratio was found in chronic severe HBV-infected patients compared with normal controls （0.0430 ±0.0198 vs 0.0316 ±0.0134, P = 0.011）. CONCLUSION： In chronic severe HBV-infected patients, the intestinal permeability is raised significantly. The elevated intestinal permeability facilitates endotoxin into the serum, and then causes endotoxernia. In so doing, the raised intestinal permeability may play a very important role in the pathogenesis of heavy degree chronic hepatitis B.

关 键 词：重度慢性乙型病毒性肝炎 乳果糖 甘露醇 肠黏膜通透性 

分 类 号：R512.62[医药卫生—内科学]