肝硬化患者并发全身炎症反应综合征时细菌移位的临床研究  

Clinical study of bacterial translocation in patients with liver cirrhosis complicated with SIRS

作　　者：瞿志军[1] 余希[1] 赵蔚[1] 庄桂龙[1] 李国航[1] 邝建玉[1] 

机构地区：[1]深圳市龙岗中心医院感染科,广东深圳518000

出　　处：《中西医结合肝病杂志》2016年第6期333-335,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：广东省医学科研基金项目(No.A2013624)

摘　　要：目的:探讨肝硬化患者并发全身炎症反应综合征(SIRS)时细菌移位的发生情况及检测技术。方法:将50例肝硬化患者按照SIRS诊断标准分为SIRS组和无SIRS组。应用16SrRNA基因测序技术比较两组患者外周静脉血和腹水中细菌DNA阳性率,并比较两组患者血浆内毒素、尿乳果糖(L)/甘露醇(M)比值以及细胞因子TNF-α、IL-6、IL-8的水平。结果:SIRS组患者外周静脉血和腹水中细菌DNA PCR阳性率高于无SIRS组(P<0.01)。PCR阳性组血浆内毒素水平及尿乳果糖/甘露醇(I/M)水平高于PCR阴性组(P<0.01),SIRS组内毒素及尿乳果糖/甘露醇(L/M)水平高于无SIRS组(P<0.01)。PCR阳性组患者外周血TNF-α、IL-6、IL-8阳性率显著高于PCR阴性组(t=3.24、4.37、2.89;P<0.05)。结论:肝硬化患者合并SIRS与肠道细菌移位密切相关,细菌DNA 16SrRNA基因测序技术有助于诊断早期肠道细菌移位。Objective： To investigate the occurrence and detection technology of bacterial translocation in patients with liver cirrhosis com- plicated with SIRS. Methods： Fifty cases are departed into SIRS group and non-SIRS group according to the diagnosis standard of SIRS. The positive rate of bacterial DNA within peripheral blood and ascites between the two groups is compared by the technique of 16S ribosomal RNA （rRNA） gene sequencing. The levels of endotoxin, lactulose to mannitol ratio in urine, TNF-α, IL-6 and IL-8 are compared between the two groups, either. Results： The positive rate of bacterial DNA within peripheral blood and ascites in SIRS group were higher than non-SIRS group （P 〈0.01 ）;The levels of endotoxin and lactulose to mannitol ratio in urine in positive group were higher than negative group by polymerase chain reaction（P 〈0.01 ） ; The levels of endotoxin and lactulose to mannitol ratio in urine in SIRS group were higher than non-SIRS group（P 〈 0.01 ）. The levels of TNF-α, IL-6 and IL-8 in positive group by PCR were significantly higher than negative group（t = 3.24,4.37,2.89 ;P 〈 0.05）. Conclusion： Patients with liver cirrhosis combined with SIRS have a intently close relationship with bacterial translocation, the tech- nique of 16S ribosomal RNA （rRNA） gene sequencing in bacterial DNA is helpful to definite early-state bacterial translocation.

关 键 词：肝硬化 肠道细菌移位 全身炎症反应综合征 16SrRNA基因测序 

分 类 号：R575.2[医药卫生—消化系统] R459.7[医药卫生—内科学]