内毒素及其结合因子与酒精性肝病的相关性

目的　探讨内毒素及其结合因子与酒精性肝病 (ALD)发生、发展的关系。方法　选取 3 0例ALD患者和 3 0例健康体检者分别作为ALD组与对照组 ,ALD组按临床体征、肝功能和(或 )肝脏B超、病理分为轻、中、重型。均分别检测丙氨酸氨基转移酶 (ALT)、天冬氨酸氨基转移酶(AST)、总胆红素 (TBIL)、内毒素、脂多糖结合蛋白 (LBP)、sCD14、载脂蛋白A1 、A2 、B (ApoA1、ApoA2、ApoB)等指标。 结果　ALD组的ALT、AST、TBIL、内毒素、LBP、sCD14与对照组比较均显著升高 (P <0 .0 5 ) ,且轻、中型ALD患者内毒素、sCD14增加非常显著 (P <0 .0 1) ;轻、中型ALD患者ApoA1、ApoA2显著升高 (P <0 .0 5 ) ,重型患者则减少 ;ApoB在各组患者中变化不明显。内毒素与LBP和sCD14显著相关 (P <0 .0 5 )。结论　内毒素及其结合因子在不同程度的酒精性肝病中的表达有差异 ,提示它们在酒精性肝病的发生、发展中起一定的作用

Relationship between endotoxin, lipopolysaccharide-binding protein and alcoholic liver disease

Objective To study the effects of endotoxin and lipopolysaccharide(LPS) binding protein on the development of alcoholic liver disease(ALD).Methods Thirty patients were divided into minimal group,intermediated group and severe group according to the physical signs,liver function and pathology.serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(T BIL),endotoxin,lipopolysaccharide binding protein(LBP),sCD14,apolipoproteinA1?A2?B(ApoA1,ApoA2,ApoB)were detected and the relationship between them and ALD was analyzed.Results ALT,AST,BIL,endotoxin,LBP,sCD14,ApoA1 and ApoA2 were increased( P <0.05),particularly in minimal ALD and intermediate ALD( P <0.01).ApoA1 and ApoA2 were reduced in severe ALD.ApoB remained unchanged.The elevations of LBP and sCD14 were related to the concentration of endotoxin.Conclusion The levels of endotoxin and LPS binding protein are positively correlated with the advancing of ALD and may play roles in the pathogenesis and development of alcoholic liver disease. \