Llovet J M, Bartolí R, Planas R, Cabré E, Jimenez M, Urban A, Ojanguren I, Arnal J, Gassull M A
Department of Gastroenterology, Hospital Germans Trias i Pujol, Badalona, Catalunya, Spain.
Gut. 1994 Nov;35(11):1648-52. doi: 10.1136/gut.35.11.1648.
Bacterial translocation occurs in ascitic cirrhotic rats, but its association with ascites infection is unknown. The aim of this study was to assess the relation between bacterial translocation and ascites infection in cirrhotic rats. Male Sprague-Dawley rats were induced to cirrhosis with intragastric CCl4. Ascitic fluid, portal and peripheral blood, mesenteric lymph nodes, liver and spleen samples were cultured before death in those cirrhotic rats with less (group A) or more (group B) than 250 polymorphonuclear neutrophils/mm3 in ascitic fluid, as well as in healthy control rats. Histological examination of jejunum, ileum, and caecum was also performed. Bacterial translocation occurred in 45% of ascitic rats (without differences between groups A and B), but in 0% controls (p = 0.01). Bacterial translocation was associated with positive ascitic fluid culture in 60% of the cases. In all of them the same bacterial species was isolated in both mesenteric lymph node and ascitic fluid. Submucosal caecal oedema (100%), ileal lymphangiectasia (41%), and caecal inflammatory infiltrate (41%) occurred in ascitic rats, the last being associated with ascitic fluid positive culture (p = 0.04). These results suggests that bacterial translocation occurs frequently in ascitic cirrhotic rats, and may play a permissive, but not unique, part in a number of ascites infections. Whether histological changes seen in cirrhotic ascitic rats favour bacterial translocation remains to be elucidated.
细菌易位在肝硬化腹水大鼠中会发生,但其与腹水感染的关联尚不清楚。本研究的目的是评估肝硬化大鼠中细菌易位与腹水感染之间的关系。雄性Sprague-Dawley大鼠通过胃内注射四氯化碳诱导肝硬化。在腹水多形核中性粒细胞/mm³少于250(A组)或多于250(B组)的肝硬化大鼠以及健康对照大鼠死亡前,对腹水、门静脉和外周血、肠系膜淋巴结、肝脏和脾脏样本进行培养。还对空肠、回肠和盲肠进行了组织学检查。45%的腹水大鼠发生细菌易位(A组和B组之间无差异),但对照组为0%(p = 0.01)。60%的病例中细菌易位与腹水培养阳性相关。在所有这些病例中,在肠系膜淋巴结和腹水中分离出相同的细菌种类。腹水大鼠出现盲肠黏膜下水肿(100%)、回肠淋巴管扩张(41%)和盲肠炎性浸润(41%),最后一项与腹水培养阳性相关(p = 0.04)。这些结果表明,细菌易位在肝硬化腹水大鼠中频繁发生,并且可能在一些腹水感染中起促成作用,但并非唯一作用。肝硬化腹水大鼠中所见的组织学变化是否有利于细菌易位仍有待阐明。