华静 李继强 曾民德 张达荣 董晓旭 200001 上海第二医科大学附属仁济医院 上海消化疾病研究所 中华肝脏病杂志 1998 0 0 2


    关键词：肝硬化 肠道菌群 肠源性内毒素 期刊 zhgzbzz 0 临床研究 fur -->


    

【摘要】 目的 研究肝硬化患者肠道菌群的变化，并分析血浆内毒素水平与肠道细菌的关系。 方法 对 37例肝硬化患者和 18例健康者粪便中 8种常见的厌氧菌及需氧菌进行定量研究，以偶氮基质显色法测外周血内毒素。 结果 (1)肝硬化患者双歧杆菌、拟杆菌、真杆菌量明显低于正常组，而大肠杆菌、产气荚膜杆菌量高于正常组 (P<0.05)； (2)肠菌失调程度与肝功能 Child-Pugh分级有关； (3)内毒素水平与大肠杆菌量存在相关性。 结论 肝硬化患者存在肠道菌群失调，具有代表性的厌氧菌减少，需氧菌增多。需氧革兰氏阴性杆菌大量繁殖可能是引起肝硬化肠源性内毒素血症的一个重要因素。

    

A STUDY OF INTESTINALFLORA IN PATIENTS WITH CIRRHOSIS

Hua Jing, Li Jiqiang, Zeng Mingde, et al. Shanghai Institute of Digestive Disease, Shanghai Second MedicalUniversity, Shanghai 200001

【 Abstract】 Objective To investigate changes ofintestinal flora and relationship between intestinal flora and plasma endotoxin levels incirrhotic patients. Methods Feces from 18 healthy adults and37 patients with cirrhosis were cultured aerobically and anaerobically. Plasma endotoxinconcentrations were determined with a limulus assay. Results The number of bifidobacterium, eubacterium, bacteroidesdecreased significantly(P<0.05) in patients with cirrhosis than in healthy controls,but escherichia coli and clostridium perfringens increased markedly. The degree of changesin intestinal flora was related to the severity of liver dysfunction. A significantcorrelation was observed between plasma endotoxin levels and the number of E.coli incirrhotic patients. Conclusions In cirrhotic patients, anaerobicbacteria decreased and aerobic bacteria increased. The overgrowth of aerobic gram-negativebacteria may play an important role in the development of endotoxemia in cirrhosis.

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