肝硬化患者肠黏膜通透性与Child—Pugh分级的相关性研究  

Relationship of Child-Pugh classification with intestinal permeability in patients with cirrhosis

作　　者：覃慧敏[1] 周晓琳[1] 冯芳[1] 叶丰[1] 谢迎春[1] 沈雁冰[1] 

机构地区：[1]三峡大学医学院附属第一临床医院湖北省宜昌市中心人民医院感染科,湖北宜昌443003

出　　处：《临床内科杂志》2011年第1期44-46,共3页Journal of Clinical Internal Medicine

摘　　要：目的探讨肝硬化患者肠黏膜通透性（IP）与Child—Pugh分级的相关性及肠道去污剂对肝硬化患者肠道屏障功能及肝功能状态的影响。方法按Child—Pugh分级标准将76例肝硬化患者分为A、B、C3组，并选择30例体检者作为对照组，采用高压液相色谱法检测各组患者尿液乳果糖／甘露醇排出比（L／M）；给予76例肝硬化患者选择性肠道去污剂，比较用药前后各组患者肝功能Child—Pugh分级和肠黏膜通透性。结果肝硬化患者尿乳果N／甘露醇排出比明显高于对照组（0．208±0．025vs0．057±0．019），肝硬化患者按Child。Pugh分级各组尿乳果糖／甘露醇排出比也均明显高于对照组，差异有显著性（P〈0．01）；采用Spearman等级相关分析发现，肝功能Child—Pu巾评分与乳果糖／甘露醇排出比呈正相关（r=0．658，P〈0．05）；给予肠道去污药物2周后肝硬化Child-Pugh分级各组患者尿液乳果糖／甘露醇排出比与治疗前比较均明显下降（P〈0．05），各组Child—Pugh评分均有改善。结论肝硬化患者的肠黏膜通透性与肝功能Child—Pugh评分呈正相关，即肠道通透性随肝功能下降而升高，肠黏膜通透性对于肝硬化患者的诊断和治疗有临床意义。Objective To investigate the relationship of Child-Pugh classification with intestinal permeability（IP） and the effect of intestinal detergent on intestinal barrier function and liver function in patients with cirrhosis. Methods 76 patients with liver cirrhosis were divided into stage A, B and C according to Child-Pugh staging ,30 cases of healthy individuals were enrolled as control group. The intestinal permeability and Child-Pugh classification were measured before and after the drugs were administrated. Results The L/M lever was significantly higher at Child-Pugh group than that in the control group （0. 208 ± 0. 025 vs 0. 057 ± 0.019,P 〈 0.01 ）. The L/M lever was correlated with Child-Pugh classification （ r = 0. 658, P 〈 0.05 ）. The L/M lever and Child-Pugh score were significantly decreased after therapy at Child-Pugh group （ P 〈 0.05 ）. Conclusions Intestinal permeability was significantly correlated with Child-Pugh classification,and increased with the decrease of the liver function, indicating that it was important to the diagnosis and treatment in patients with cirrhosis.

关 键 词：肠黏膜通透性 Child—Pugh分级 肝硬化 

分 类 号：R575.2[医药卫生—消化系统]