抗生素治疗对自发性细菌性腹膜炎氧化应激动态变化的影响。

The influence of antibiotic treatment on the dynamics of oxidative stress in spontaneous bacterial peritonitis.

作者信息

Dănulescu Răzvana Munteanu, Ciobică A, Stanciu C, Trifan Anca

机构信息

Discipline of Gastroenterology and Hepatology University Alexandru loan Cuza, Iaşi.

Department of Biology, University of Medicine and Pharmacy Grigore T. Popa, Iaşi.

出版信息

Rev Med Chir Soc Med Nat Iasi. 2013 Jul-Sep;117(3):598-604.

PMID:24502022

Abstract

UNLABELLED

Bacterial infections play an important role in liver cirrhosis complications, being together with variceal bleeding and hepatic encephalopathy an important cause of morbidity and mortality in cirrhotic patients. Spontaneous bacterial peritonitis (SBP) is a major complication of liver cirrhosis, with a significant mortality. Recent studies have demonstrated the involvement of oxygen free radicals in the pathogenesis of liver cirrhosis, but the role of oxidative stress in the development of SBP is not very clear yet.

PURPOSE

This study aims to evaluate the role of oxidative stress in the pathogenesis of spontaneous bacterial peritonitis and its changes after therapy.

MATERIAL AND METHODS

The study is a prospective case-control, which included 33 patients divided into 3 groups: group I- 10 patients with decompensated cirrhosis and SBP, group II - 17 patients diagnosed with decompensated liver cirrhosis with ascites, and group Ill - 6 patients with compensated liver cirrhosis. The control group consisted of 19 healthy subjects recruited from hospital staff, adapted to patients by age and sex. Malonildyaldehida (MDA), a product of lipid peroxidation, was dosed in the blood and ascitic fluid of patients by assay thiobarbituric acid reactive substances (TBARS).

RESULTS

Serum MDA significantly increased in the group with decompensated cirrhosis and SBP compared with the control group. MDA levels in ascitic fluid showed a statistically significant increase in the SBP group compared with patients without SBP. There was a decrease of MDA after 6 months of antibiotic treatment compared with the initial stage, while MDA values increased in the absence of treatment.

CONCLUSIONS

The study demonstrates the increased oxidative stress markers in the blood and ascitic fluid of cirrhotic patients with SBP, which can be considered a predictor of SBP and also a marker of treatment response.

KEYWORDS

SPON-

摘要

未标注

细菌感染在肝硬化并发症中起重要作用，与静脉曲张破裂出血和肝性脑病一起，是肝硬化患者发病和死亡的重要原因。自发性细菌性腹膜炎（SBP）是肝硬化的主要并发症，死亡率很高。最近的研究表明氧自由基参与了肝硬化的发病机制，但氧化应激在SBP发生发展中的作用尚不完全清楚。

目的

本研究旨在评估氧化应激在自发性细菌性腹膜炎发病机制中的作用及其治疗后的变化。

材料与方法

本研究为前瞻性病例对照研究，纳入33例患者，分为3组：I组-10例失代偿期肝硬化合并SBP患者，II组-17例诊断为失代偿期肝硬化腹水患者，III组-6例代偿期肝硬化患者。对照组由19名从医院工作人员中招募的健康受试者组成，根据年龄和性别与患者匹配。通过检测硫代巴比妥酸反应物质（TBARS）来测定患者血液和腹水中脂质过氧化产物丙二醛（MDA）的含量。