Wang X D, Andersson R, Soltesz V, Wang W Q, Ar'Rajab A, Bengmark S
Dept. of Surgery, Lund University, Sweden.
Scand J Gastroenterol. 1994 Dec;29(12):1117-21. doi: 10.3109/00365529409094897.
Bacterial infections and bacteremia in acute liver failure may at least partly be attributed to translocation of enteric bacteria. Attempts to prevent or treat such infections by the use of antibiotics may instead result in overgrowth of surviving microbes.
In the present study, normal saline (1.5 ml/100 g body weight), phosphatidylcholine (1.5 ml/100 g body weight), and phosphatidylinositol (1.5 ml/100 g body weight) were orally administered by means of a gastric tube both 12 h and 30 min before operation. Effects of enteric administration of phospholipids on the prevention of enteric bacterial translocation, intestinal and mucosal mass, and enterocyte protein contents in acute liver failure induced by subtotal liver resection in the rat were evaluated.
The incidence of bacterial translocation increased significantly 2 and 4 h after 90% hepatectomy as compared with sham-operated animals. Enteric administration of phospholipids, however, significantly reduced the incidence of bacterial translocation after 90% hepatectomy. Phospholipid treatment prevented the postoperative decrease in intestinal mucosal mass and enterocyte protein content.
Enteral administration of phospholipids thus seems to protect against translocation of enteric bacteria and prevent against a decrease in intestinal mucosal mass and enterocyte protein content after subtotal hepatectomy in the rat.
急性肝衰竭中的细菌感染和菌血症至少部分归因于肠道细菌的易位。然而，使用抗生素预防或治疗此类感染可能反而会导致存活微生物过度生长。
在本研究中，于手术前12小时和30分钟经胃管分别口服给予生理盐水（1.5毫升/100克体重）、磷脂酰胆碱（1.5毫升/100克体重）和磷脂酰肌醇（1.5毫升/100克体重）。评估肠道给予磷脂对预防大鼠肝大部切除诱导的急性肝衰竭中肠道细菌易位、肠及黏膜质量和肠上皮细胞蛋白含量的影响。
与假手术动物相比，90%肝切除术后2小时和4小时细菌易位发生率显著增加。然而，肠道给予磷脂可显著降低90%肝切除术后细菌易位的发生率。磷脂治疗可防止术后肠黏膜质量和肠上皮细胞蛋白含量下降。
因此，肠道给予磷脂似乎可防止大鼠肝大部切除术后肠道细菌易位，并防止肠黏膜质量和肠上皮细胞蛋白含量下降。
