[Bacterial endotoxinemia and risk of hemorrhage from oesophageal varicose veins in patients with liver cirrhosis].

This work was designed to substantiate the necessity of estimating serum bacterial endotoxin levels in patients with liver cirrhosis (LC) for the prognostication of the risk of bleeding from oesophageal varices. The prospective cohort study included 90 patients with LC and clinical signs of portal hypertension. Total endotoxin of Gram-negative bacteria was measured by the activated particle method. The intensity of endotoxemia was estimated using the end-point turbidimetric test (variant of LAL test). Pronounced endotoxemia was associated with acute bleeding from oesophageal varices. Its severity in the patients with the history of hemorrhage was higher than in the absence of this complication. The endotoxin level in the range from 0 to 4 ng/ml suggested low probability of hemorrhage; its risk increased significantly at the endotoxin level in excess of 4.1 ng/ ml. It is concluded that the severity of endotoxemia in LC patients correlates with the degree of oesophageal vein dilation and hemorrhage, the endotoxin level of 4 ng/ml being a reliable diagnostic criterion for the associated risks.