摘要
目的研究乙型肝炎相关性肝衰竭不同黄疸证型的肠道菌群特点及与内毒素血症的关系。方法对30例乙型肝炎相关性肝衰竭患者(分为阳黄组15例,阴阳黄组15例)和10例健康人(健康组)行大便培养,测定肠道菌群:肠球菌、肠杆菌、类杆菌、双歧杆菌、乳酸杆菌的数量;以偶氮基质显色法检测外周血的血浆内毒素。结果 (1)乙型肝炎相关性肝衰竭阳黄证与健康组比较肠道菌群变化表现为肠球菌、肠杆菌的显著增多(P<0.05,P<0.01)。(2)阴阳黄证与健康组比较肠道菌群变化表现为肠球菌显著增多(P<0.01),而肠杆菌与健康组比较稍有增加,但差异无统计学意义(P>0.05);双歧杆菌明显减少(P<0.001),乳酸杆菌亦减少(P<0.05)。(3)乙型肝炎相关性肝衰竭患者与健康组比较,血浆内毒素水平均显著增加(P<0.05,P<0.01),并且阴阳黄组血浆内毒素水平较阳黄组升高,差异有统计学意义(P<0.01)。结论乙型肝炎相关性肝衰竭"阳黄-阴阳黄-阴黄"过程中,随着脾虚症状的加重,需氧菌增多、厌氧菌减少,血浆内毒素水平逐步升高,存在阴黄化机制的病理变化。
Objective To study the relationship between the intestinal flora characteristics and endotoxemia in different jaundice syndrome of hepatitis B-related liver failure. Methods By stool cultures of 30 patients with hepatitis B-related liver failure （15 cases were yang jaundice and 15 cases were yin-yang jaundice） and 10 healthy persons, the amounts of intestinal flora including enterococci, enteric bacilli, Baeteroides, Bifidobacterium, Lactobacillus were determined. The plasma endotoxin levels of these persons were measured using limulus polyphemus test. Results （1） Com- pared with those of health group, the amounts of enterococci and enteric bacilli in yang jaun- dice group were significantly increased （P〈0.05 ,P〈0.01）. （2） Compared with those of health group, the amount of enterococci in yin-yang jaundice group was increased significantly （P〈O.01）, and the amount of enteric bacilli was increased slightly without statistically significant（P〉O.05）, Bifidobacteri- um and Lactobacillus＇ were reduced obviously （P〈O.O1 and P〈O.05）. （3） Compared with those of health group, plasma endotoxin levels of hepatitis B-related liver failure were significantly in- creased （P〈O.05 and P〈0.O1） and yin-yang jaundice group was higher than yang jaundice group. Conclusion In the ＂yang jaundice-yin-yang jaundice-yin jaundice＂ process of hepatitis B-related liver failure, the degree of imbalance of intestinal flora is more and more obvious, aerobes are increasing and anaerobes are reducing, plasma endotoxin levels are gradually heightened with the aggravation of the spleen deficiency symptoms dice mechanism. It is a pathophysiological basis of yin jaundice mechanism.
出处
《湖南中医药大学学报》
CAS
2013年第1期128-131,共4页
Journal of Hunan University of Chinese Medicine
基金
湖南省中医药科研计划项目(201137)
湖南中医药大学青年教师科研基金项目(201039)
