Fukui H, Matsumoto M, Tsujita S, Takaya A, Kojima H, Matsumura M, Tsujii T
Third Department of Internal Medicine, Nara Medical University, Kashihara Japan.
J Gastroenterol Hepatol. 1994 Nov-Dec;9(6):582-6. doi: 10.1111/j.1440-1746.1994.tb01565.x.
Plasma endotoxin levels in 12 cirrhotics with bleeding from oesophageal varices and 50 cirrhotics without bleeding were measured by the chromogenic assay after the pretreatment of sample by perchloric acid (HClO4) and triethylamine. Endotoxin in cirrhotics with bleeding from varices was significantly higher than those without bleeding. In patients with bleeding, endotoxin increased for 3 days after the bleeding, first in the supernatant fraction and then in the precipitate fraction by HClO4 treatment. Peak plasma alpha 1-acid glycoprotein and haptoglobin were observed 3 days after the bleeding. Alpha 1-antitrypsin gradually increased for 14 days. Transferrin did not markedly change. The endotoxin-binding capacity of transferrin and alpha 1-acid glycoprotein increased immediately after bleeding and thereafter decreased, but that of alpha 1-antitrypsin tended to increase in the recovery period. In summary, the plasma endotoxin concentration and endotoxin-binding capacity of alpha 1-acid glycoprotein and transferrin were shown to have increased after bleeding from varices by this new method. There may be a close relationship between endotoxaemia and acute phase reaction in this situation.
采用生色法，通过高氯酸（HClO4）和三乙胺对样本进行预处理后，测量了12例食管静脉曲张出血的肝硬化患者和50例未出血的肝硬化患者的血浆内毒素水平。静脉曲张出血的肝硬化患者的内毒素水平显著高于未出血者。出血患者在出血后3天内，内毒素水平升高，首先出现在上清液部分，然后在高氯酸处理后的沉淀部分出现。出血后3天观察到血浆α1-酸性糖蛋白和触珠蛋白达到峰值。α1-抗胰蛋白酶在14天内逐渐升高。转铁蛋白无明显变化。转铁蛋白和α1-酸性糖蛋白的内毒素结合能力在出血后立即升高，随后下降，但α1-抗胰蛋白酶的内毒素结合能力在恢复期有升高趋势。总之，通过这种新方法显示，静脉曲张出血后血浆内毒素浓度以及α1-酸性糖蛋白和转铁蛋白的内毒素结合能力均升高。在这种情况下，内毒素血症与急性期反应之间可能存在密切关系。
