亚急性肝衰竭患者血清内毒素结合蛋白水平研究

目的:探讨血清内毒素结合蛋白(LBP)在慢加急性(亚急性)肝衰竭发生发展中的意义.方法:采用双抗体夹心ELISA法检测亚急性肝衰竭患者入院及入院第二周时血清LBP水平.结果:58例亚急性肝衰竭组入院时血清LBP值(107.01±40.92)ng/mL显著高于正常对照组(42.11±21.08)ng/mL(P<0.01).入院第二周时血清LBP值比较,好转(56.99±26.42)ng/mL明显低于死亡(116.70±40.88)ng/ml,未发生自发性细菌性腹膜炎、肝性脑病、肝肾综合征、电解质紊乱者明显低于发生上述情况者(P均<0.05).发生医院感染组与未发生医院感染组比较,入院时及入院第二周时LBP水平差异无统计学意义(P>0.05).结论:亚急性肝衰竭患者血清LBP明显升高,LBP水平与是否合并细菌感染无明显关系,动态监测LBP水平有助于判断肝衰竭患者预后,LBP水平迅速下降者预后较好.

Study on level of serum lipopolysaccharide binding protein in patients with subacute liver failure

Objective：To investigate the significance of serum lipopolysaccharide binding protein（LBP） in the development and progression of subacute liver failure. Methods：The serum LBP levels of 58 patients with subacute liver failure were detected by ELISA on admission and two weeks after admission.Results ：The serum level of LBP in patients with subacute liver failure were higher than that in normal controls（ 107.01±40.92）ng/ml vs （42.11±21.08）ng/ml,P=0.001]. Two weeks after admission,the serum level of LBP in improving group was significantly lower than that in death group （56.99±26.42）ng/ml vs （116.70±40.88 ）ng/ml, P〈0.05]. The serum level of LBP in the patients without spontaneous bacterial peritonitis,or hepatic eneephalopathy,or hepatorenal syndrome,or electrolyte disturbances were significantly lower than that in the patients with complications mentioned above （P〈0.05）. Comparing the serum levels of LBP in the patients on admission and two weeks after admission, there was no significant difference between the hospital infection group and the no infection group（P〉0.05）.Conclusion：The serum levels of LBP in patients with subacute liver failure obviously advance. Dynamic monitoring the serum levels of LBP is usdeful for estimating prognosis of subacute liver failure.The patients with the quickly descend levels of LBP could have better prognosis.The levels of LBP has no obvious relation with complicating bacterial infection.