肝硬化患者肠黏膜通透性改变与肝功能分级的关系研究  

Study on the relationship between change of intestinal mucosal permeability and liver function classification in patients with liver cirrhosis

作　　者：王丽[1] 张瑞 Wang Li;Zhang Rui(Clinical Laboratory,The Sixth People's Hospital of Zhengzhou,Zhengzhou 450015,China)

机构地区：[1]郑州市第六人民医院医学检验科,郑州450015

出　　处：《国际医药卫生导报》2023年第1期105-110,共6页International Medicine and Health Guidance News

摘　　要：目的探讨肝硬化患者肠黏膜通透性改变与肝功能分级的关系。方法以2020年11月至2022年4月经郑州市第六人民医院医学检验科收治肝硬化患者96例为观察组,按Child-Pugh肝功能分级分为A组(35例)、B组(43例)、C组(18例)3个亚组;同期选择无肝硬化的健康体检者40例为对照组。A组男25例、女10例,年龄(55.01±8.71)岁;B组男30例、女13例,年龄(55.19±8.76)岁;C组男14例、女4例,年龄(55.34±8.81)岁;对照组男27例、女13例,年龄(54.52±8.56)岁。收集粪便标本,通过细菌培养测定肠道主要菌群变化,测定肠黏膜通透性指标[D-乳酸(D-LAC)、内毒素(ETX)及二胺氧化酶(DAO)]。Pearson相关性分析分析肠黏膜通透性指标之间的相关性,Spearman相关性分析分析肠黏膜通透性指标与Child-Pugh肝功能分级的相关性,并使用受试者工作特征曲线(ROC)分析肠黏膜通透性指标的预测价值。计量资料采用F检验、独立样本t检验,计数资料采用χ^(2)检验。结果A、B、C组肠杆菌[(8.61±0.42)lgCFU/g、(8.95±0.39)lgCFU/g、(9.22±0.56)lgCFU/g]、肠球菌数目[(7.75±0.46)lgCFU/g、(8.42±0.87)lgCFU/g、(9.28±0.63)lgCFU/g]均高于对照组[(8.12±0.68)lgCFU/g、(7.18±0.71)lgCFU/g],乳杆菌[(9.08±0.63)lgCFU/g、(8.60±0.48)lgCFU/g、(8.04±0.76)lgCFU/g]、双歧杆菌数目[(9.15±0.58)lgCFU/g、(8.54±0.61)lgCFU/g、(7.96±0.82)lgCFU/g]均低于对照组[(9.85±1.01)lgCFU/g、(9.97±0.96)lgCFU/g],差异均有统计学意义(均P<0.05)。随Child-Pugh肝功能分级提高,肠杆菌、肠球菌数目呈上升趋势,乳杆菌、双歧杆菌数目呈下降趋势,差异均有统计学意义(均P<0.05)。A、B、C组D-LAC[(5.83±2.63)mg/L、(8.75±3.27)mg/L、(10.16±3.58)mg/L]、ETX[(10.53±4.36)U/L、(12.67±5.12)U/L、(23.08±9.37)U/L]、DAO水平[(34.06±10.36)U/L、(40.12±11.72)U/L、(43.07±14.20)U/L]均高于对照组[(3.92±2.27)mg/L、(3.72±2.51)U/L、(3.65±1.63)U/L],差异均有统计学意义(均P<0.05)。B、C组D-LAC、DAO水平均�Objective To investigate the relationship between change of intestinal mucosal permeability and liver function classification in patients with liver cirrhosis.Methods A total of 96 patients with liver cirrhosis who were treated in Clinical Laboratory,The Sixth People's Hospital of Zhengzhou from November 2020 to April 2022 were selected as an observation group,and were divided into three subgroups,group A,B,and C(35,43,and 18 cases),according to the Child-Pugh liver function classification.During the same period,40 healthy controls without liver cirrhosis were selected as a control group.Group A included 25 males and 10 females,aged(55.01±8.71)years;group B included 30 males and 13 females,aged(55.19±8.76)years;group C included 14 males and 4 females,aged(55.34±8.81)years;the control group included 27 males and 13 females,aged(54.52±8.56)years.The fecal sample was collected,the changes of main intestinal flora were determined by bacterial culture,and the intestinal mucosal permeability indexes[D-lactic acid(D-LAC),endotoxin(ETX),and diamine oxidase(DAO)]were determined.Pearson correlation analysis was used to analyze the correlations among intestinal mucosal permeability indexes,Spearman correlation analysis was used to analyze the correlations between intestinal mucosal permeability indexes and Child-Pugh liver function classification,and the receiver operating characteristic curve(ROC)was used to analyze the predictive values of intestinal mucosal permeability indexes.F test and independent-sample t test were used for the measurement data andχ^(2) test was used for the count data.Results The numbers of enterobacterium[(8.61±0.42)lgCFU/g,(8.95±0.39)lgCFU/g,and(9.22±0.56)lgCFU/g]and enterococcus[(7.75±0.46)lgCFU/g,(8.42±0.87)lgCFU/g,and(9.28±0.63)lgCFU/g]in group A,B,and C were all higher than those in the control group[(8.12±0.68)lgCFU/g and(7.18±0.71)lgCFU/g],and the numbers of Lactobacillus[(9.08±0.63)lgCFU/g,(8.60±0.48)lgCFU/g,and(8.04±0.76)lgCFU/g]and bifidobacterium[(9.15±0.58)lgCFU/g,(8.54

关 键 词：肝硬化 肠黏膜通透性 肝功能分级 

分 类 号：R575.2[医药卫生—消化系统]