| 邵长春1 丁连安2 牛冬光2 成红刚1 曹淑成1.胰十二指肠切除术后肠黏膜屏障损伤与肠道细菌移位的临床研究[J].,2011,11(1):111-114 |
| 胰十二指肠切除术后肠黏膜屏障损伤与肠道细菌移位的临床研究 |
| Clinical study on gut barrier dysfunction and bacterial translocation inpatients after duodenopancreatectomy surgery |
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| DOI： |
| 中文关键词: 肠黏膜屏障损伤 细菌移位 D- 乳酸 PCR 全身炎症反应综合征 |
| 英文关键词: gut barrier dysfunction bacterial translocation D-lactate PCR SIRS |
| 基金项目:黎介寿院士肠道屏障研究专项基金（LJS_201013） |
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| 中文摘要: |
| 目的：探讨胰十二指肠切除手术后肠道细菌移位(BT)与术后全身炎症反应综合征(SIRS)关系。方法：40 例择期行胰十二指肠
切除手术患者,于术前和术后1、3、5 天采集外周血,进行血浆D- 乳酸，全血细菌DNA 检测. 全血DNA 提取后进行PCR 扩增，采
用靶基因为大肠杆菌特异性β 半乳糖苷酶基因和16SrRNA 基因。观察患者术后10 天以监测SIRS 情况。结果：术前PCR 检测全
血细菌DNA 均为阴性,术后共有13 例阳性。术后出现全身炎症反应综合征(SIRS)的患者PCR 阳性率为85.7 %（12/14）,无SIRS
组为3.8%( 1/26)（P< 0.01)。PCR 阳性组SIRS 发生率为93.2%(12/13),阴性组为7.4%(2/27)( P <0.01).PCR 阳性的患者外周血血浆
D- 乳酸浓度较PCR 阴性者明显升高( P< 0.01) ,有SIRS 的患者外周血血浆D- 乳酸浓度较无SIRS 患者明显升高( P< 0.01)。结论：
胰十二指肠切除术后肠黏膜屏障损伤与BT 关系密切,术后SIRS 和与BT 密切相关。PCR 技术对术后SIRS 有较好的早期预警价
值。 |
| 英文摘要: |
| Objective: To investigate the relationship between bacterial translocation and acute systemic inflammatory state (SIRS)
in patients who underwent duodenopancreatectomy surgery. Methods: 40 patients who underwent selective duodenopancreatectomy operations
were observed. Blood were collected before surgery and 1, 3, 5d after surgery to detect plasma D-lactate and extract DNA.PCR
analysis was performed with β-Galactosidase gene of Eschenchia coli and 16SrRNA gene as target gene. The SIRS of all the patients
were observed for 10 days. Results: All the PCR results before operation were negative, while there was positive in 13 patients (32.5%,
13/40) after duodenopancreatectomy surgery. The positive PCR rate in SIRS was 85.7% (12/14), which was remarkably higher than that
without SISR (3.8%, 1/26) (p<0.01). 92.3% of the patient (12/13) with positive PCR result had SIRS while 7.4% patients (2/27) with negative
PCR result did have SIRS (p<0.01). The plasma levels of D-lactate in patient with positive PCR result was significantly higher than
those of the patients with negative PCR result (p<0.01). The plasma levels of D-lactate in patient with SIRS was significantly higher than
those of patients without SIRS (p<0.01). Conclusion: Increased intestinal permeability had relationship with bacterial translocation and
BT was closely related to SIRS after duodenopancreatectomy operations. The positive PCR result might be a useful early warning sign of
postoperative SIRS. |
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