Barut Ibrahim, Kaya Selcuk
Department of General Surgery, Suleyman Demirel University Medical School, Isparta, Turkey.
Department of Microbiology, Suleyman Demirel University Medical School, Isparta, Turkey.
Adv Clin Exp Med. 2014 Mar-Apr;23(2):197-203. doi: 10.17219/acem/37054.
Many experimental studies have verified that obstructive jaundice (OJ) causes bacterial translocation (BT).
The aim of this study was to assess to whether C-Reactive Protein (CRP) can be used to detect bacterial translocation induced by biliary obstruction.
Twenty rats were divided into two groups containing 10 rats each: sham-operated controls and the obstructive jaundice (OJ) group. All procedures were performed aseptically. After an upper midline incision, the common bile duct (CBD) was identified, mobilized, ligated and divided. The sham-operated animals had a similar incision, followed by mobilization of the CBD, without ligation or division. Ten days after the first operation, a second laparotomy was performed. Blood samples were collected for culture and serum CRP analysis. In addition, liver, spleen, and mesenteric lymph node (MLN) specimens were taken for microbiological culture to determine the presence of BT. BT was considered positive if there was any bacterial growth in the MLN, liver, spleen, or blood cultures; a lack of bacterial growth indicated a negative BT.
The OJ group had significantly higher rates of bacterial translocation than the sham-operated group (p = 0.002). Mean CRP levels (ng/mL) were 8.7 ± 11.8 and 18.6 ± 17.2 in the sham-operated group and the OJ group respectively. There was no significant difference in mean CRP levels between the two groups (p = 0.257). Mean CRP levels were 4.5 ± 4.3 and 24.9 ± 16.4 in the BT (-) and BT (+) groups respectively (p = 0.003). A marked increase in CRP levels paralleled an increase in BT.
This study has demonstrated a direct relationship between BT and CRP levels in an experimental OJ model.
许多实验研究已证实梗阻性黄疸（OJ）会导致细菌移位（BT）。
本研究旨在评估C反应蛋白（CRP）是否可用于检测胆管梗阻诱导的细菌移位。
将20只大鼠分为两组，每组10只：假手术对照组和梗阻性黄疸（OJ）组。所有操作均在无菌条件下进行。经上腹部正中切口后，识别、游离、结扎并切断胆总管（CBD）。假手术动物做类似切口，随后游离CBD，但不结扎或切断。首次手术后10天，进行第二次剖腹手术。采集血样进行培养及血清CRP分析。此外，取肝脏、脾脏和肠系膜淋巴结（MLN）标本进行微生物培养，以确定是否存在细菌移位。如果MLN、肝脏、脾脏或血培养中有任何细菌生长，则细菌移位被视为阳性；无细菌生长表明细菌移位为阴性。
OJ组的细菌移位率显著高于假手术组（p = 0.002）。假手术组和OJ组的平均CRP水平（ng/mL）分别为8.7±11.8和18.6±17.2。两组间平均CRP水平无显著差异（p = 0.257）。BT（-）组和BT（+）组的平均CRP水平分别为4.5±4.3和24.9±16.4（p = 0.003）。CRP水平的显著升高与细菌移位的增加平行。
本研究在实验性OJ模型中证明了细菌移位与CRP水平之间存在直接关系。
