选择性肠道去污染对肝硬化自发性细菌性腹膜炎肠黏膜通透性的影响  

Effects of selective digestive tract decontamination on intestinal permeability in cirrhosis spontaneous bacterial peritonitis

作　　者：刘树人[1] 罗显荣[1] 陈汉先[1] 欧阳石[1] 李灼亮[1] 

机构地区：[1]解放军第458医院全军肝病中心,广东广州510600

出　　处：《胃肠病学和肝病学杂志》2011年第8期719-721,共3页Chinese Journal of Gastroenterology and Hepatology

基　　金：总后勤部卫生部专项科研项目(174号)

摘　　要：目的观察肝硬化自发性细菌性腹膜炎(SBP)肠黏膜通透性和形态结构的变化及选择性肠道去污染对其通透性的影响。方法按诊断标准,将28例肝硬化SBP患者随机分为治疗组(15例)和对照组(13例),在肝硬化腹水常规治疗和全身应用抗生素抗感染的基础上,治疗组加用诺氟沙星口服选择性肠道去污染(SDD)。采用酶联免疫吸附法(ELISA)测定治疗前后二胺氧化酶(DAO)、D-乳酸(D-Lac)和内毒素(ET)的水平;HE常规染色观察肠黏膜形态结构的变化。结果 常规治疗可降低DAO、D-Lac和ET水平(P<0.05),加用SDD可进一步减轻肠黏膜损伤,降低肠黏膜通透性,防止细菌移位。结论 SDD对肝硬化SBP肠黏膜屏障具有保护作用。Objective To study the intestinal permeability changes and the effects of the selective digestive tract decontamination（SDD） in the cirrhosis patients with spontaneous bacterial peritonitis（SBP）.Methods According to the cirrhosis SBP diagnostic criteria,28 diagnosed patients were randomly divided into two groups： treatment group（15 cases） and control group（13 cases）.All the patients were administered the cirrhotic ascitis conventional therapy and antibiotics,besides that,the patients in the treatment group were orally given Norfloxacin as SDD.The serum diamine oxidase（DAO）,D-lactate（D-Lac） and endotoxin（ET） were measured by enzyme linked immune absorbent（ELISA） before and after the treatment,the intestinal mucosal barrier microstructure was microscopically examined with hematoxylin eosin stain.Results The conventional therapy could decrease the serum levels of DAO,D-Lac and ET（P0.05）,SDD could furthermore alleviate the intestinal mucosal injury,lower the intestinal mucosal permeability and prevent the bacterial and ET translocation（P0.05）.Conclusion The SDD has the prophylactic effect on the intestinal barrier of the cirrhosis SBP.

关 键 词：选择性肠道去污染 肝硬化 自发性细菌性腹膜炎 肠黏膜通透性 肠黏膜 

分 类 号：R575.2[医药卫生—消化系统]