| 关于肠黏膜屏障功能衰竭临床分期标准的初步探讨 |
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| 引用本文： | 朱疆依 陈村龙 王继德 邓润枢. 关于肠黏膜屏障功能衰竭临床分期标准的初步探讨[J]. 实用医学杂志, 2008, 24(19): 3327-3330 |
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| 作者姓名： | 朱疆依 陈村龙 王继德 邓润枢 |
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| 作者单位： | 南方医科大学 |
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| 摘 要： | 目的 初步建立肠粘膜屏障功能衰竭(Intestinal barrier failure,IBF)的临床分期标准。方法 选取消化系统恶性肿瘤、肝硬化、炎性肠病等患者共50例作为病例组，选取25例健康志愿者作为对照组，均口服双糖探针后检测样本尿液中乳果糖/甘露醇（lactulose/mannitol，L/M）含量以评价肠道通透性，同时采集其新鲜粪便行菌群分析，记录其临床指标及实验室指标，分析病例组与对照组的临床表现、肠道通透性、肠菌群及免疫指标间的关系。结果 同对照组(0.02938±0.00725)相比，病例组尿L/M比值(0.06694±0.02343)显著增高，差异有统计学意义（t＝9.874，P<0.01）。不同程度菌群失调患者肠道通透性无显著差异（F＝2.285，P＝0.113）。随着患者腹胀及腹泻程度的增高，肠道通透性增高及中重度菌群失调的比率也增加。病例组C反应蛋白（47.8±33.5mg/L VS 3.2±2.6mg/L）、血浆内毒素（5.806±4.219EU/ml VS 0.018±0.056EU/ml）及血清IL-6(22.19±8.45pg/ml VS 6.24±0.13pg/ml)水平较之对照组均有显著升高（P均<0.01）。结论 根据患者的临床症状、肠粘膜通透性、肠菌群状态及免疫指标间的关系，可初步建立IBF的临床分期标准。
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| 关 键 词： | 肠粘膜屏障功能衰竭 肠粘膜通透性 肠道菌群 临床分期 |
| 收稿时间： | 2008-03-25 |
The initially approach of clinical stage on intestinal barrier failure |
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| Abstract: | Objective To initially set up the standand of clinical stage on intestinal barrier failure(IBF). Methods Fifty patients with gasteroenterological cancer, hepatic cirrhosis, IBD and twenty-five volunteers as contrast group were recruited in this study. Urine collection was used to assess intestinal permeability by gas chromatography after oral administration of double-sugar probe. Stool collection was used to analyze gut flora. Clinical indexs (including abdominal distention, diarrhea, hemafecia) and experimental indexs (including WBC, CRP, LPS, IL-6) were recorded. The relationship among symptom, permeability, gut flora and immune indexs was analyzed. Result The urine lactulose/mannitol ratios in patients(0.06694±0.02343) were significantly higher than those of volunteers(0.02938±0.00725)(t= 9.87,P<0.01）. The differences of intestinal permeability among different degree of gut flora disorder in patients were not so significant. As the extent of abdominal distension and diarrhea increased,the rates of increased permeability and severe microbe disorder also raised. The levels of C-reaction protein, LPS and IL-6 in patients were significantly higher than those of contrast group（P<0.01）. Conclusion On basis of the relationships among symptom, intestinal permeability, state of gut flora and immune indexs, we can initially set up the standand of clinical stage on IBF. |
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