梗阻性黄疸与肠源性内毒素血症的临床研究

以梗阻性黄疸 (OJ)和胆囊结石患者为实验组和对照组 ,探讨梗阻性黄疸是否影响消化道粘膜屏障功能造成肠源性内毒素血症。分光光度法监测外周血中二胺氧化酶 (DAO)和内毒素 (ET)的活性。与正常组比较 ,术前梗阻性黄疸组的DAO活性明显升高 (t=3.176 ,P <0 0 0 1) ;而术前胆囊结石组与正常人DAO活性差异无显著性(t=0 .0 0 77,P >0 0 5 )。梗黄组术前DAO活性明显高于术后 (t=3.86 2 3,P =0 .0 114 )。梗黄组和胆囊结石组术前、术后的DAO、ET活性分别比较 ,差异有显著性 ,但梗黄组的ET含量术后较术前升高 (P <0 0 5 )。相关分析表明梗黄组术前的DAO与ET相关 ,相关系数为r=0 .74 7,P <0 0 1。梗阻性黄疸所致的消化道粘膜屏障功能异常可能与肠源性内毒素血症密切相关。

Clinical study on the relationship between obstructive jaundice and gut original endotoxemia

To determine the relationship between obstructive jaundice and gut-derived endotoxemia,74 patients were divided into two group,cholelithiasis cholecystolithiasis gruop(n=30)and obstructive jaundice(OJ)group(n=44).The concentration of diamine oxidase and endotoxin were detected in systemic circulation by spectrophotometry.The concentration of plasma diamine oxidase and endotoxin in patients with obstructive jaundice were significant higher in the period of pre-operation (p<0 001).Compared with control,DAO of cholelithiasis cholecystolithiasis group in pre-operation has no insignificant increase.( p >0 05).Our study also showed the relationship between DAO and ET in OJ group before operation.( r =0 747, P <0 01)The disorder of digestive mucosal barrier from obstructive jaundice may result into gut original endotoxemia.