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目的 研究肝硬化患者小肠细菌过度生长与血浆内毒素、白细胞介素 (IL) 2、IL 6及肿瘤坏死因子 (TNF) α水平的关系。方法 71例肝硬化患者行葡萄糖 氢呼气试验 (GHBT)检测小肠细菌过度生长情况 ,鲎实验检测血浆内毒素水平及ELISA法检测血浆IL 2、IL 6及TNF α水平 ;分析血浆内毒素与血浆IL 2、IL 6及TNF α水平之间的关系。结果 71例肝硬化患者中 ,GHBT阳性者为 1 8例(2 5 3 % )。肝硬化伴与不伴小肠细菌过度生长者血浆内毒素分别为 (0 71 5± 0 2 2 9)Eu/L、(0 379±0 2 2 3)Eu/L(P <0 0 0 1 ) ;IL 2分别为 (1 9 1 5± 4 60 )ng/L、(9 41± 6 69)ng/L ;IL 6分别为 (93 2 9± 2 7 37)ng/L、(53 2 2± 2 8 31 )ng/L ;TNF α分别为 (42 1 8± 1 6 91 )ng/L、(2 7 72± 1 7 0 6)ng/L(P值均 <0 0 1 )。肝硬化患者血浆内毒素与IL 2、IL 6及TNF α存在直线正相关 ,相关系数分别为 0 894、0 857、0 845(P值均 <0 0 0 1 )。结论 肝硬化伴小肠细菌过度生长患者血浆内毒素、IL 2、IL 6、TNF α水平均增高 ,提示肝硬化小肠细菌过度生长是导致肝硬化患者出现内毒素血症的原因之一。肝硬化患者血浆内毒素水平升高与血浆IL 2、IL 6、TNF α水平升高相关 ,提示肝硬化患者内毒素血症可刺激机体产生多
Objective To study the relationship between intestinal bacterial overgrowth and plasma levels of endotoxin, interleukin (IL) 2, IL 6 and tumor necrosis factor (TNF) α in cirrhotic patients. Methods 71 cases of liver cirrhosis patients underwent glucose hydrogen breath test (GHBT) to detect intestinal bacterial overgrowth, 鲎 test of plasma endotoxin levels and ELISA assay of plasma IL 2, IL 6 and TNFα levels; analysis of plasma endotoxin and plasma IL 2, IL 6 and TNF α levels. Results Among the 71 patients with cirrhosis, the positive rate of GHBT was 18 (25.3%). The levels of plasma endotoxin in cirrhotic patients with and without excessive bacterial growth were (0 71 5 ± 0 2 2 9) Eu / L and (0 379 ± 0 2 2 3) Eu / L (P 0 01 0) ; IL 2 were (19 15 ± 4 60) ng / L, (9 41 ± 6 69) ng / L respectively; IL 6 were (93 2 9 ± 2 7 37) ng / L, ± 2 8 31 ng / L, respectively. The levels of TNF α were (42 1 8 ± 1 6 91) ng / L and (2 7 72 ± 1 7 0 6) ng / L respectively (P all <0 0 1). There was a linear positive correlation between plasma endotoxin and IL 2, IL 6 and TNFα in patients with cirrhosis, the correlation coefficients were 0 894,0 857,0 845 respectively (P all <0 0 0 1). Conclusion The levels of endotoxin, IL 2, IL 6 and TNF α in patients with cirrhosis and small intestine bacterial overgrowth are both elevated, suggesting that bacterial overgrowth in cirrhotic patients is one of the causes of endotoxemia in cirrhotic patients. Plasma endotoxin levels in patients with cirrhosis and plasma IL 2, IL 6, TNFα levels related to suggest that patients with liver cirrhosis endotoxemia can stimulate the body to produce more