血清内毒素水平在胆道闭锁患儿术后的意义

目的探讨血清内毒素(ET)、透明质酸(HA)与胆道闭锁(BA)患儿术后肝损害、肝纤维化的关系。方法以行肝门空肠吻合(Kasai)术后的BA患儿为BA组(n=38),正常体检儿童(n=12)为对照组;BA患儿根据其胆红素水平再分成黄疸组(n=14)和无黄疸组(n=24)。由自动生化仪测肝功能,鲎三肽基质显色法测ET水平、放射免疫法测HA水平。结果 BA组患儿存在肝损害,血清ET、HA水平均较正常对照儿童高(P<0.05);BA组患儿中,黄疸患儿的肝损害较无黄疸者重,血清ET、HA水平也较无黄疸者高,差异均有统计学意义(P<0.05);血清ET水平与血清总胆红素、谷草转氨酶及HA水平呈正相关(P<0.05)。结论血清ET水平与术后BA患儿肝损害和肝纤维化密切相关,可作为术后判断BA患儿预后的有用指标。

The significance of serum endotoxin levels in postoperative children with biliary atresia

Objective To investigate the serum endotoxin(ET),hyaluronic acid(HA) levels in postoperative biliary atresia(BA) children and their relationships with liver damage and fibrosis.Methods The children after Kasai surgery were selected as the BA group(n = 38),children from normal physical examination(n = 12) as the control group.BA group divided into jaundice subgroup(n = 14) and non-jaundice subgroup(n = 24) according to the level of bilirubin.All children’s liver function was measured by automatic biochemical analyzer,the serum level of ET was measured by Limulus chromogenic tripeptide substrate assay,and the level of HA was measured by radioimmunoassay.Results Liver damage was observed in BA group,the serum levels of ET and HA were higher than the control group(P < 0.05).In BA group,the liver damage of Jaundice subgroup was severer compared with non-jaundice subgroup,serum levels of ET and HA in jaundice subgroup were also higher than that of non-jaundice subgroup(P < 0.05).There was a positive correlation between serum level of ET and total bilirubin,glutamic-oxal acetic transaminase and HA(P < 0.05).Conclusions Serum ET level is closely associated with liver damage and liver fibrosis in postoperative patients with BA.It can be a useful biomarker in monitoring the clinical outcomes of postoperative patients with BA.