肝病中的门静脉菌血症、全身菌血症及内毒素血症
Portal and systemic bacteraemia and endotoxaemia in liver disease.
作者信息
Triger D R, Boyer T D, Levin J
出版信息
Gut. 1978 Oct;19(10):935-9. doi: 10.1136/gut.19.10.935.
Abstract
Using a percutaneous transhepatic technique, blood was obtained from the portal veins of 30 patients with various hepatic disorders and examined for the presence of bacteria and endotoxin. Simultaneous samples also were drawn from hepatic and peripheral veins. In three cases, portal vein cultures grew diphtheroids, which were of doubtful significance, while all hepatic and peripheral cultures were sterile. Endotoxin was detected in seven portal vein samples; in none of these patients were the hepatic or peripheral blood samples positive. In three cases, only peripheral blood samples were positive for endotoxin. It was concluded that portal bacteraemia occurs as infrequently in patients with liver disease as in those without. Portal endotoxaemia was detected in patients with all degrees of liver disease but, even in patients with moderately severe portal hypertension, the liver may remain an effective filter of endotoxin.
摘要
采用经皮经肝技术，从30例患有各种肝脏疾病的患者门静脉获取血液，检测其中细菌和内毒素的存在情况。同时也从肝静脉和外周静脉采集样本。3例患者的门静脉培养物中生长出类白喉杆菌，其意义存疑，而所有肝静脉和外周培养物均无菌。7份门静脉样本中检测到内毒素；这些患者的肝血和外周血样本均无阳性结果。3例患者仅外周血样本内毒素呈阳性。得出的结论是，肝病患者发生门静脉菌血症的频率与无肝病患者一样低。所有程度肝病的患者均检测到门静脉内毒素血症，但即使是中度严重门静脉高压的患者，肝脏仍可能是内毒素的有效滤器。
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