Liehr H, Grün M, Brunswig D, Sautter T
Z Gastroenterol. 1976 Jan;14(1):14-23.
Endotoxins of gram-negative bacteria and of intestinal origin, insufficiently cleared by the hepatic reticulo-endothelial system are of an increasing interest within the pathogenesis of liver diseases. With purpose to obtain data concerning incidence and course of endotoxaemia in patients with liver cirrhosis an unselected group of these patients, sequentially admitted, was investigated by means of the Limulus-gelation test, regarded as most sensitive to endotoxins. At the admittance, 65% of the patients had endotoxaemia, further 14% developed endotoxaemia later. In total 79% of the patients investigated had endotoxaemia.---Bleeding from oesophageal varices was associated with endotoxaemia in 78%, functional renal impairment in 75%, consumption coagulopathy in 81%, encephalopathy in 77% and a pyrogen reaction in 82% of the patients. Regarding the Limulus assay, the dilution technique was more sensitive in detection of free endotoxaemia as opposed to the chloroform extract. It is concluded from the results that endotoxaemia in patients with liver cirrhosis is frequent and has to be viewed as relevant within the pathogeneses of chronic liver diseases.
革兰氏阴性菌及源于肠道的内毒素，若未被肝网状内皮系统充分清除，在肝脏疾病的发病机制中愈发受到关注。为获取有关肝硬化患者内毒素血症发生率及病程的数据，我们采用对内毒素最为敏感的鲎试剂凝胶试验，对一组未经过筛选、依次入院的此类患者进行了研究。入院时，65%的患者存在内毒素血症，另有14%的患者随后出现内毒素血症。总计79%的受调查患者患有内毒素血症。---78%的患者食管静脉曲张出血与内毒素血症相关，75%的患者出现功能性肾功能损害，81%的患者出现消耗性凝血病，77%的患者出现脑病，82%的患者出现热原反应。关于鲎试剂检测法，与氯仿提取物相比，稀释技术在检测游离内毒素血症方面更为敏感。从结果可以得出结论，肝硬化患者内毒素血症很常见，在慢性肝病的发病机制中必须被视为相关因素。
