慢性肝病增加肠道屏障功能损伤  

Chronic liver disease increases with damage to intestinal barrier function

作　　者：梁芬芬 汪杰[1] 李兰 袁瑜[1] 谢文瑞[1] 吴礼浩[1] 何兴祥[1] Liang Fenfen;Wang Jie;Li Lan;Yuan Yu;Xie Wenrui;Wu Lihao;He Xingxiang(Department of Gastroenterology,the First Affiliated Hospital of Guangdong Pharmaceutical University,Guangzhou 510080,China)

机构地区：[1]广东药科大学附属第一医院消化内科,广州510080

出　　处：《中华肝脏病杂志》2018年第8期612-617,共6页Chinese Journal of Hepatology

基　　金：广东省医学科学技术研究基金（B2017032）

摘　　要：目的探讨慢性肝病与肠道屏障功能的相关陛。方法收集住院患者1491例，其中慢性肝病组共741例，包括单纯性脂肪肝397例，慢性肝炎230例，肝硬化114例，无肝病组共750例。所有入组患者入院后完善肠道屏障功能生物化学指标二胺氧化酶（DAO）、D-乳酸、脂多糖，以及肝脏相关血清学指标。据资料不同分别采用t检验分析、ANOVA分析、Dunnett-t检验、四格表x^2检验、Pearson直线回归分析、logistic回归分析进行统计学分析。结果慢性肝病组较无肝病组易发生肠道屏障功能损伤[54．15％（379／741）对比18．53％（139／750），x^2=193．58，p〈0．001]。在慢性肝病组中行肝生物化学指标与肠道屏障功能的相关性分析发现，丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、Y-谷氨酰转移酶（GGT）、总胆红素异常患者较上述指标正常患者易发生肠道屏障功能的损伤垆〈0．05）。在慢性肝病组中进一步分析肝生物化学指标与肠道屏障功能生物化学指标的相关性，GGT有促进DAO作用（P〈0．05，OR〉1），ALT、AST、GGT有促进D-乳酸和脂多糖作用护〈0．05，OR〉1）。结论慢性肝病增加肠道屏障功能损伤。Objective To probe into the correlation between chronic liver disease and intestinal barrier function. Methods 1 491 cases of hospitalized patients were enrolled, of which 741 cases were of chronic liver diseases, including 397 cases of fatty liver diseases, 230 cases of chronic hepatitis, 114 cases of liver cirrhosis, and 750 cases of non-hepatic diseases. All admitted patients＇ intestinal barrier function like diamine oxidase （DAO）, D-lactate, lipopolysaccharide, and biochemical indicators of liver functions were tested. According to different data, statistical analysis was done using t-test, ANOVA, Dunnett＇s test, Z 2 test of fourfold table, Pearson＇s correlation, and binary logistic regression. Results The intestinal barrier dysfunction was more likely to occur in the chronic liver disease group than that of non-hepatic disease group [54.15% （379/741） vs. 18.53% （139/750）,Z 2 = 193.58,.P 〈 0.001]. The correlation analysis between biochemical indicators of liver function and intestinal barrier fimction in chronic liver disease group showed that alanine amino-nsferase （ALT）, aspartate aminotransferase （AST）, gamma glutamyl transferase （GGT）, and total bilirubin levels were more susceptible to intestinal barrier dysfunction than those with normal indexes （P 〈 0.05 ）. GGT had stimulated DAO （P 〈 0.05, OR 〉 1）, D-lactate （P 〈 0.05, OR 〉 1）, lipopolysaccharide （P 〈 0.05, OR 〉 1）, ALT and AST. Condusion Chronic liver disease increases with damage to intestinal barrier function.

关 键 词：肠道屏障功能 脂肪肝 肝炎 慢性 肝硬化 

分 类 号：R575[医药卫生—消化系统]