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目的观察慢性肝病患者小肠细菌过度生长(SIBO)的情况与内毒素、血小板源生长因子PDGF)水平及血清肝纤维化指标的关系。方法采用乳果糖氢呼气试验(LHBT)检测64例慢性肝病患者SIBO情况,鲎试验检测血浆内毒素,双抗体夹心ELISA检测PDGF,放免法检测透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原肽氨基末端肽(PⅢNP)、Ⅳ型胶原(Ⅳ.C)水平。分析SIBO与内毒素、血清肝纤维化指标之间的关系。结果64例慢性肝病患者中,LHBT阳性22例(34.4%),慢性肝病伴与不伴SIBO的血浆内毒素为(62±19)和(31±13)pg/ml;PDGF为(211±77)和(136±57)pg/ml;HA为649±189)和(394±210)ng/ml;LN为(139±24)和(110±35)μg/L;Ⅳ.C为(156±41)和(112±51)μg/L;PⅢNP为(32±10)和(21±12)μg/L(P值均<0.01)。慢性肝病患者血浆内毒素水平与PDGF水平呈直线正相关(r=0.803,P<0.01);血浆内毒素、PDGF水平与血清肝纤维化指标呈正相关。结论SIBO是慢性肝病患者出现高内毒素血症的原因之一,其引起的肠源性内毒素血症可能参与促进肝纤维化发生、发展的过程。
Objective To observe the relationship between intestinal bacterial overgrowth (SIBO), endotoxin, platelet-derived growth factor (PDGF) and serum markers of liver fibrosis in patients with chronic liver disease. Methods SIBO was measured in 64 patients with chronic liver disease by lactobacillus hydrogen expiration test (LHBT). Plasma endotoxin was detected by 鲎 test and PDGF was detected by double antibody sandwich ELISA. Hyaluronic acid (HA), laminin (LN) , Type Ⅲ procollagen peptide amino terminal peptide (PⅢNP), type Ⅳ collagen (Ⅳ.C) levels. Analysis of the relationship between SIBO and endotoxin, serum markers of liver fibrosis. Results Totally 22 patients (34.4%) had LHBT positive in the 64 patients with chronic liver disease, the plasma endotoxin levels in chronic liver disease patients with or without SIBO were (62 ± 19) and (31 ± 13) pg / ml, ) And (136 ± 57) pg / ml for HA; 649 ± 189 for HA and 394 ± 210 ng / ml for HA; (139 ± 24) and ± 41 and 112 ± 51 μg / L respectively; PⅢNP was (32 ± 10) and (21 ± 12) μg / L, respectively (all P <0.01). The level of plasma endotoxin in patients with chronic liver disease was positively correlated with the level of PDGF (r = 0.803, P <0.01). The level of plasma endotoxin and PDGF was positively correlated with the level of serum liver fibrosis. Conclusions SIBO is one of the causes of high endotoxemia in patients with chronic liver disease. The intestinal endotoxemia caused by it may be involved in the process of promoting the development and progression of hepatic fibrosis.