| Objective: Endotoxin is a kind of lipopolysaccharide in the cell wall layer of gram negative bacterium and other microorganism including chlamydia, rickettsia, spirochete or something else. When they died or propagated actively amount of Endotoxin will be released. And when the plasma Endotoxin level was beyond 0.1EU/ml it is called endotoxemia which can lead to liver injury increasingly in patients undergoing liver disease. High level endotoxin in plasma may up-regulate some cytokines that aggravate liver disease. With the development of endotoxemia the patients undergoing liver disease will have a bad prognosis because serious septic shock, multiple organ failure (MOF), disseminated intravascular coagulation (DIC) or other serious complications. Endotoxemia is a frequent finding in liver disease patients especially liver cirrhosis patients, the incidence of which is high as 84.3%. Generally, endotoxemia in liver cirrhosis patients were intestinalendotoxemia (IETM). It is one of the main reasons of endotoxemia that intestinal flora of the liver cirrhosis patients in the uncompensated period were disturbance. The cytokines including tumor necrosis factor alpha, interleukin-1 alpha, interleukin-6, interferon, colony stimulating factor, transforming growth foctor, chemotactic factor and other cytokines were secreted by mononuclear phagocye, which can injury the liver function of patients with endotoxemia. The study is conducted to investigate the clinical significance of Bifid Triple Viable that was used to treat endotoxemia of Liver cirrhosis on the base of general therapy, and to observe the change of endotoxin and some cytokines (IL-1α, IL-6, TNFα) in plasma during the treatment, and also to do some useful work which are helpful to the theory for clinic using.Methods : 60 hospitalizing patients with liver cirrhosis in the uncompensated period (50 male patients, aged 39-71 years; 10 female patients, aged 50-69 years) were included in present study. The patients of the study excluded those who was companied with serious infection, hepatoma or major organ failure, and also excluded those who are applying antibiotic or other drugs that can affect whose intestines flora. The patients satisfied the conditions were separated into two groups at random. One is control group (n=30) treated with general therapy, another is BTV group (n=30) treated with Bifid Triple Viable on the base ofgeneral therapy. In BTV group the Bifid Triple Viable capsule was took orally continuously for 10 days in the dose of two capsules one time, 3 times one day. The fasting venous blood of patients in both of the groups was phlebotomized before therapy and after 10 days therapy. The plasma was separated to detect endotoxin accurately by dynamic limulus lysate nephometric assay, and to detect the level of IL-1α, IL-6 and TNFα by enzyme-linked immunosorbent assay (ELISA). Before and after the therapy ALT, AST, BUN and Cr were detected by biochemistry method. Results : (1) The compare of all the items before therapy: The endotoxin, IL-1α, IL-6, TNFα, ALT, AST, BUN and Cr in BTV group were 0.297 EU/ml, 13.39 pg/ml, 12.94 pg/ml, 8.96 pg/ml, 48.30 mg/ml, 61.85 mg/ml, 5.59 mg/ml and 60.63 mg/ml respectively. That in control group were as follows: endotoxin (0.255 EU/ml), IL-1α (11.86 pg/ml), IL-6 (11.45 pg/ml), TNFα (10.94 pg/ml), ALT (50.30 mg/ml), AST (54.78 mg/ml), BUN (5.29 mg/ml) and Cr (59.59 mg/ml) respectively. There were no significant differences when the items in control group compared correspondingly with that in BTV group (p>0.05). (2) The compare of all the items before and after therapy in BTV group: The endotoxin, IL-1α, IL-6, TNFα, ALT, AST, BUN and Cr in BTV group after therapy were 0.132 EU/ml, 8.32 pg/ml, 4.96 pg/ml, 4.43 pg/ml,38.78 mg/ml, 47.87 mg/ml, 4.97 mg/ml and 55.45 mg/ml respectively. Compared correspondingly with that before therapy the differences were significant (p<0.05) except BUN (p>0.05). (3) The compare of all the items before and after therapy in control group: The...
|
PDF Full Text Request