Yamamoto Y, Sezai S, Sakurabayashi S, Yoshiura K, Sanui S, Morita T, Shimizu T, Yoshino K, Iwase T, Hirano M
Division of Gastroenterology, Tokyo Metropolitan Polic Hospital.
Nihon Shokakibyo Gakkai Zasshi. 1990 Apr;87(4):997-1002.
In the patients with liver cirrhosis, endotoxin levels were measured in portal venous system by the toxicolor method and the mechanism of endotoxemia in the peripheral vein was studied. On endotoxin levels in portal venous system, the superior mesenteric vein had the highest level. Endotoxemia was observed most frequently in the superior mesenteric vein (78%), and 50% in the truncal portal vein and 55% in the peripheral vein. The hepatic "endotoxin extraction ratio" which is considered to reflect the Kupffer cell function of clearing endotoxin and the severity of cirrhosis were not related each other. On the other hand, in view of the extrahepatic portal shunt, systemic endotoxemia appeared more frequently in the patients with the other collaterals than the esophageal varices. Therefore, it was concluded that systemic endotoxemia in liver cirrhosis was related with the type of extrahepatic portal collaterals.
对肝硬化患者采用毒色法测定门静脉系统内毒素水平，并研究外周静脉内毒素血症的发生机制。在门静脉系统内毒素水平方面，肠系膜上静脉内毒素水平最高。内毒素血症最常出现在肠系膜上静脉（78%），在门静脉主干为50%，在外周静脉为55%。被认为反映库普弗细胞清除内毒素功能的肝脏“内毒素提取率”与肝硬化严重程度之间并无关联。另一方面，鉴于肝外门静脉分流，存在其他侧支循环而非食管静脉曲张的患者发生全身性内毒素血症更为频繁。因此，得出结论，肝硬化患者的全身性内毒素血症与肝外门静脉侧支循环类型有关。
