Fiuza C, Salcedo M, Clemente G, Tellado J M
Surgical Infections Unit, Department of Surgery, Hospital General Universitario Gregorio Marañon, Madrid, Spain.
J Infect Dis. 2000 Aug;182(2):526-33. doi: 10.1086/315742. Epub 2000 Jul 24.
Bacterial infections are frequent, life-threatening complications in cirrhotic patients. This study investigated in vivo neutrophil migration and phagocytic activity in cirrhotic patients with advanced liver disease, in liver transplant recipients, and in healthy volunteers, by use of the skin window technique. Complement receptor type III (CR3) expression was also measured in blood and elicited neutrophils. Neutrophil migration to skin windows and neutrophil in vivo phagocytosis of heat-killed Escherichia coli were significantly decreased in cirrhotic patients compared with healthy controls. Neutrophil migration and phagocytosis were decreased in cirrhotic patients with previous episodes of bacterial infection compared with noninfected patients. Expression of CR3 in circulating neutrophils was significantly higher in cirrhotic patients, whereas it was significantly reduced in elicited neutrophils of cirrhotic patients with previous bacterial infection. These data suggest that deficient neutrophil recruitment to the infection site and impaired phagocytic activity may contribute to bacterial infections in cirrhotic patients with advanced liver disease.
细菌感染是肝硬化患者常见的、危及生命的并发症。本研究采用皮肤窗技术，调查了晚期肝病肝硬化患者、肝移植受者和健康志愿者体内的中性粒细胞迁移和吞噬活性。还检测了血液及诱导产生的中性粒细胞中Ⅲ型补体受体（CR3）的表达。与健康对照相比，肝硬化患者中性粒细胞向皮肤窗的迁移及对热灭活大肠杆菌的体内吞噬作用显著降低。与未感染患者相比，既往有细菌感染史的肝硬化患者中性粒细胞迁移和吞噬作用降低。肝硬化患者循环中性粒细胞中CR3的表达显著升高，而既往有细菌感染史的肝硬化患者诱导产生的中性粒细胞中CR3表达显著降低。这些数据表明，晚期肝病肝硬化患者中性粒细胞向感染部位募集不足及吞噬活性受损可能导致细菌感染。
