Lau J Y, Chung S C, Leung J W, Ling T K, Yung M Y, Li A K
Department of Surgery, Chinese University of Hong Kong.
Br J Surg. 1996 Feb;83(2):181-4.
Forty patients with acute calculous cholangitis had successful endoscopic drainage. Bile from nasobiliary drains and venous blood was collected at 0, 12, 24, 36 and 48 h after endoscopy. Endotoxin levels were measured by the chromogenic Limulus Amoebocyte Lysate assay. There was a significant reduction in both bile and serum endotoxin levels after endoscopic drainage (P < 0.001). Endotoxaemia occurred when bile endotoxin reached 10(3) EU/ml and rose exponentially beyond this threshold. Significant association was demonstrated between both bile and serum endotoxins to the clinical features of cholangitis (P < 0.05). No correlation was evident between serum endotoxin and the parameters of white cell count, serum bilirubin and alkaline phosphatase (r = 0.53, 0.00 and 0.00 respectively). Endoscopic drainage is effective in lowering bile and serum endotoxin levels and clinical signs and symptoms reliably predict endotoxaemia.
40例急性结石性胆管炎患者接受内镜引流成功。在内镜检查后0、12、24、36和48小时收集鼻胆管引流胆汁和静脉血。采用显色鲎试剂法测定内毒素水平。内镜引流后胆汁和血清内毒素水平均显著降低（P<0.001）。当胆汁内毒素达到10³EU/ml时发生内毒素血症，超过此阈值呈指数上升。胆汁和血清内毒素与胆管炎临床特征之间均显示出显著相关性（P<0.05）。血清内毒素与白细胞计数、血清胆红素和碱性磷酸酶参数之间无明显相关性（r分别为0.53、0.00和0.00）。内镜引流可有效降低胆汁和血清内毒素水平，临床体征和症状可可靠预测内毒素血症。
