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目的:探讨肝硬化患者血清二胺氧化酶(diamine oxidase,DAO)和内毒素(endotoxin,ETX)水平的变化及临床意义。方法:52例肝硬化患者(肝硬化组),采用分光光度法和鲎试剂偶氮显色基质法检测治疗前、后外周血清中DAO和ETX水平,选择同期15名健康体检者作为对照组,并进行比较。结果:肝硬化组治疗前DAO水平高于对照组(P<0.01)。肝硬化组Child-pugh A级与B级患者治疗前ETX水平比较差异无统计学意义(P>0.05),余各分级间DAO,ETX水平差异均有统计学意义(P<0.01);治疗后C级患者DAO水平升高(P<0.05),余各分级DAO,ETX水平均明显降低(P<0.01)。合并腹腔积液患者DAO和ETX水平明显高于无腹腔积液患者(P<0.01);肝硬化患者DAO与ETX水平呈正相关(r=0.28,P<0.05)。结论:DAO可作为判断肠黏膜损伤的一项较敏感指标;肝硬化患者肠黏膜通透性升高,可能是导致内毒素血症发生的因素之一,且与肝硬化病情轻重有关。
Objective: To investigate the changes and clinical significance of serum levels of diamine oxidase (DAO) and endotoxin (ETX) in cirrhotic patients. Methods: Fifty-two patients with liver cirrhosis (cirrhosis group) were enrolled in this study. The levels of DAO and ETX in the peripheral blood serum of the patients with cirrhosis were detected by spectrophotometry and arsenic colorimetric method. Fifteen healthy subjects were selected as the control group, And compare. Results: The level of DAO in cirrhosis group before treatment was higher than that in control group (P <0.01). There was no significant difference in ETX levels between Child-pugh class A and B before treatment (P> 0.05), but there were significant differences in the levels of DAO and ETX among all grades (P <0.01). After treatment The level of DAO in patients with C level increased (P <0.05), while the levels of DAO and ETX in all levels were significantly decreased (P <0.01). The levels of DAO and ETX in patients with ascites were significantly higher than those without ascites (P <0.01). There was a positive correlation between DAO and ETX in cirrhotic patients (r = 0.28, P <0.05). Conclusion: DAO can be used as a more sensitive indicator of intestinal mucosal injury. The increased permeability of intestinal mucosa in patients with liver cirrhosis may be one of the factors leading to endotoxemia, which is related to the severity of liver cirrhosis.