内毒素在肝硬化患者病情演变中的重要性及干预价值

发布时间：2018-04-16 23:33

本文选题：内毒素 + 肝硬化　；参考：《宁夏医科大学》2014年硕士论文

【摘要】：目的通过对慢性肝炎及肝硬化患者血清内毒素及肝功能相关指标的检测，探讨血清内毒素定量水平与肝硬化Child-pugh分级的关系。为微生态制剂对肝硬化的影响提供临床佐证。方法以2012年1月至2013年6月宁夏医科大学总医院感染性疾病科收住的慢性肝炎及肝硬化患者为研究对象。其中慢性肝炎（中度）组20例，肝硬化组96例。肝硬化组随机分为对照组25例，实验组71例。实验组按Child-pugh分级分为A级26例、B级24例、C级21例。各组均给予常规治疗。肝硬化实验组给予口服微生态制剂—双歧杆菌乳杆菌三联活菌片（金双歧）治疗8周，检测各组患者血清内毒素定量。与对照组比较、肝硬化实验组随着Child-Pugh评分分级的增加、血清中的内毒素水平逐渐增加，与Child-pugh分级呈明显的相关性，实验组治疗后血清内毒素水平显著降低。结果与慢性肝炎组比较：肝硬化组内毒素水平慢性肝炎组（P0.05、有统计学意义）。实验组予以口服药物金双歧维持治疗8周后、血清内毒素水平较治疗前明显改善（P0.05、有统计学意义）。肝硬化实验组：随着肝硬化Child-Pugh分级评分的增加，血清中内毒素水平及总胆红素定量逐渐增高，白蛋白逐渐下降，凝血酶原时间逐渐延长。血清内毒素、肝功能指标（PT、TB、ALB）水平较治疗前具有统计学意义(P0.05)，与对照组相比差异具有统计学意义(P0.05)。Spearman’s相关性分析显示，血清内毒素水平与Child-PughA、B、C分级存在在直线正相关性（r=0.906，P0.05）；血清内毒素与血清凝血酶原时间、总胆红素与白蛋白均存在直线相关性。结论肝硬化组内毒素水平慢性肝炎组。随着肝硬化Child-Pugh分级评分的增加，患者血清中内毒素及总胆红素定量增加，，凝血酶原时间延长，白蛋白下降，在肝硬化不同Child-Pugh分级中存在明显差异；血清内毒素水平、总胆红素定量、凝血酶原时间及白蛋白与Child-Pugh评分有直线相关性，内毒素对Child-Pugh评分有明显的影响作用，对判断肝脏疾病严重程度有重要的参考依据，也为微生态制剂对肝硬化的影响提供临床佐证。
[Abstract]:Objective to investigate the relationship between serum endotoxin and Child-pugh grade in patients with chronic hepatitis and cirrhosis.To provide clinical evidence for the effect of microecological preparation on liver cirrhosis.Methods from January 2012 to June 2013, patients with chronic hepatitis and cirrhosis received from infectious diseases department of Ningxia Medical University General Hospital were studied.There were 20 cases of chronic hepatitis (moderate) group and 96 cases of cirrhosis group.The cirrhosis group was randomly divided into control group (n = 25) and experimental group (n = 71).According to Child-pugh classification, the experimental group was divided into 26 cases of grade A, 24 cases of grade B and 21 cases of grade C.All groups were given routine treatment.The experimental group of liver cirrhosis was treated with oral bifidobacterium bifidobacterium triplex bifidobacterium tablet for 8 weeks, and the serum endotoxin was measured.Compared with the control group, the level of serum endotoxin in the experimental group of liver cirrhosis increased gradually with the increase of Child-Pugh score, and was significantly correlated with the Child-pugh grade. The level of serum endotoxin in the experimental group decreased significantly after treatment.Results compared with chronic hepatitis group, the level of endotoxin in liver cirrhosis group was significantly higher than that in chronic hepatitis group (P 0.05).After 8 weeks of oral administration of gold bifidus, the serum endotoxin level in the experimental group was significantly improved than that before treatment (P 0.05).Experimental group of liver cirrhosis: with the increase of Child-Pugh grade of cirrhosis, the level of endotoxin in serum and the quantity of total bilirubin increased gradually, albumin decreased gradually and prothrombin time was prolonged gradually.The levels of serum endotoxin and liver function were significantly higher than those before treatment (P 0.05), and the correlation analysis showed that compared with the control group, the levels of serum endotoxin and liver function were significantly higher than those of the control group.The level of serum endotoxin was positively correlated with Child-Pugh Agna BU C grade, and there was a linear correlation between serum endotoxin and serum prothrombin time, total bilirubin and albumin.Conclusion the level of endotoxin in cirrhosis group was higher than that in chronic hepatitis group.The serum endotoxin and total bilirubin were increased, prothrombin time prolonged and albumin decreased with the increase of liver cirrhosis Child-Pugh grading.Total bilirubin quantification, prothrombin time and albumin have linear correlation with Child-Pugh score, endotoxin has obvious effect on Child-Pugh score, which has important reference basis for judging the severity of liver disease.It also provides clinical evidence for the effect of microecological preparation on liver cirrhosis.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R575.2

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