文章摘要
王仰亮 丁连安 牛冬光 刘均杰 周广兴.肠屏障功能障碍与胃癌恶液质关系的临床研究[J].,2016,16(11):2109-2112
肠屏障功能障碍与胃癌恶液质关系的临床研究
Clinical Study on the Relationship between Intestinal Barrier Dysfunction andGastric Carcinoma associated Cachexia
  
DOI:
中文关键词: 内毒素  恶液质  肠屏障  胃癌  肿瘤坏死因子-alpha
英文关键词: Endotoxin  Cachexia  Intestinal barrier  Gastric cancer  Tumor necrosis factor-alpha
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作者单位
王仰亮 丁连安 牛冬光 刘均杰 周广兴 青岛大学青岛大学附属医院普外科 
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中文摘要:
      目的:观察胃癌恶液质患者血浆内毒素(LPS)水平、血浆D- 乳酸(D-LAC)水平、血浆二胺氧化酶(DAO)水平及肿瘤坏死因子alpha (TNF-alpha)水平,初步探讨肠屏障功能障碍与胃癌恶液质的关系。方法:选取2014 年3 月至2014 年12 月我院普外科预行手术治疗 的胃癌恶液质患者30 例,年龄及性别匹配的胃癌非恶液质患者50 例,健康对照者80 例,采用偶氮显色鲎试验法定量测定外周 血LPS 水平,改良分光光度法测定外周血D-LAC 水平,ELISA 法测定血浆DAO水平及TNF-alpha水平,并记录各组身高、体质量、 总蛋白、白蛋白及血红蛋白等指标。结果:胃癌恶液质组血浆LPS水平、D-LAC水平、血浆DAO水平及TNF-alpha水平显著高于胃癌 非恶液质组[LPS:(0.33 ± 0.09)EU/mLvs (0.17± 0.03)EU/mL,P<0.05;D-LAC:(1.82± 0.10)mg/L vs (1.47± 0.07)mg/L,P<0.05;DAO: (4.38± 0.65)ug/Lvs (2.71± 0.52)ug/L,P<0.05;TNF-alpha:(0.51 ± 0.13)ug/L vs (0.30± 0.16)ug/L,P<0.05];对照组血浆LPS 水平、 D-LAC水平、血浆DAO 水平及TNF-alpha水平显著低于非恶液质组[LPS:(0.07± 0.03)EU/mL vs (0.17± 0.03)EU/mL,P<0.05;D-LAC: (0.81± 0.74)mg/L vs (1.47± 0.07)mg/L,P<0.05;DAO:(1.84± 0.15)ug/L vs (2.71± 0.52)ug/L,P<0.05;TNF-alpha:(0.11± 0.12)ug/L vs (0.30± 0.16)ug/L,P<0.05]。胃癌恶液质组(r=0.94,P<0.01)、非恶液质组(r=0.93,P<0.01)及对照组(r=0.91,P<0.01)血浆LPS水平均与 TNF-alpha呈显著正相关。结论:胃癌恶液质患者的肠黏膜通透性增加,可发生内毒素易位,其血浆LPS 水平与TNF-alpha水平呈显著正 相关。
英文摘要:
      Objective:To observe the plasma level of endotoxin(LPS), D-lactic acid(D-LAC), diamine oxidase(DAO) and tumor necrosis factor (TNF-alpha) in patients with gastric carcinoma associated cachexia, and to investigate the relationship between intestinal barrier dysfunction and gastric carcinoma associated cachexia.Methods:Thirty cachectic gastric cancer patients, fifty age- and sex- matched non-cachectic gastric cancer patients, and eighty healthy controls were enrolled in this study between March 2014 and December 2014. Azo chromogenic limulus test was performed to detect the endotoxin level in the peripheral blood of cancer patients and healthy controls. D-lactic acid level were detected by ultraviolet spectrophotometry, TNF-alpha level and the DAO level were detected by enzyme-linked immunosorbent assay, and relevant parameters including height, weight, albumin, hemoglobin were also recorded before operation.Results:The level of endotoxin, the level of D-LAC, the level of DAO and the level of TNF-琢in cachectic gastric cancer patients were significantly higher than non-cachectic gastric cancer patients. [LPS: (0.33± 0.09) EU/mL vs (0.17± 0.03) EU/mL, P<0.05; D-LAC: (1.82± 0.10) mg/L vs (1.47± 0.07) mg/L, P<0.05; DAO: (4.38± 0.65) ug/L vs (2.71± 0.52) ug/L, P<0.05; TNF-alpha: (0.51± 0.13) ug/L vs (0.30± 0.16) ug/L, P<0.05]; Levels of plasma endotoxin in the control group, levels of D-LAC, serumlevels of DAO and TNF-aloha lev- els were significantly lower than non-cachexia group. [ LPS: (0.07± 0.03) EU/mL vs (0.17± 0.03) EU/mL, P<0.05; D-LAC: (0.81± 0.74) mg/L vs (1.47± 0.07) mg/L, P<0.05; DAO: (1.84± 0.15) ug/L vs (2.71± 0.52) ug/L, P<0.05; TNF-alpha: (0.11± 0.12) ug/L vs (0.30± 0.16) ug/L, P<0.05]. Cachectic gastric cancer patients (r=0.94, P<0.01), non-cachectic gastric cancer patients (r=0.93, P<0.01) and control groups (r=0.91, P<0.01) significantly and positively correlated with the plasma LPS and TNF-alpha.Conclusion:Increased per- meability of the intestinal mucosa in cachectic gastric cancer patients and endotoxin translocation may occur, its plasma LPS levels and levels of TNF-alpha were significantly correlated.
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