肝硬化患者小肠细菌过度生长及其外周血单个核细胞TLR4表达的变化

doi:10.3969/j.issn.1672-5069.2017.06.022

摘要/Abstract

摘要： 目的探讨肝硬化患者小肠细菌过度生长（SIBO）和外周血单个核细胞表面TLR4表达的变化。方法采用乳果糖-氢呼气试验（LHBT）检测40例肝硬化患者和16例正常人小肠细菌生长情况,使用流式细胞仪检测外周血单个核细胞表面TLR4表达。结果肝硬化患者SIBO检出率为42.5%（17/40）,显著高于正常人的6.3%（1/16,P<0.01）;肝硬化患者外周血单个核细胞表面TLR4相对表达量为（23.4±11.4）,显著高于正常人的【（14.4±5.2）,P<0.05】;17例肝硬化SIBO阳性患者外周血单个核细胞表面TLR4表达为（30.2±12.3）,显著高于23例肝硬化SIBO阴性患者【（19±8.6）,P<0.05】。结论肝硬化患者存在较高的SIBO发生率,外周血单个核细胞表面TLR4表达上调,SIBO可能通过与TLR4的作用在肝硬化病情进展中发挥作用。

关键词: 肝硬化, 小肠细菌过度生长, 内毒素, TOLL样受体4

Abstract: Objective To explore the prevalence of small intestinal bacterial overgrowth（SIBO） and the changes of Toll-like receptor 4（TLR-4） expression on the surface of peripheral blood mononuclear cells （PBMCs） in patients with liver cirrhosis. Methods SIBO was detected by lactulose hydrogen breath test and TLR-4 expression was assayed by flow cytometry in 40 cirrhotics and 16 healthy persons. Results The prevalence of SIBO in patients with liver cirrhosis was 42.5%,significantly higher than 6.3% in healthy people（P<0.01）;the expression of TLR4 on the surface of PBMCs in patients with cirrhosis was（23.4±11.4）,significantly higher than [（14.4±5.2）,P<0.05] in the control;the expression of TLR4 in 17 cirrhotic patients with SIBO-positive was （30.2±12.3）,significantly higher than[（19±8.6）,P<0.05] in 23 with SIBO-negative. Conclusions The patients with liver cirrhosis have a high incidence of small intestinal bacterial overgrowth,and the expression of TLR4 on PBMCs increases,which might play an important role in the development of cirrhosis.

Key words: Liver cirrhosis, Small intestinal bacteria overgrowth, Endotoxin, Toll-like receptor 4

陈光耀, 韩际奥, 周东晓, 高晓, 马英杰. 肝硬化患者小肠细菌过度生长及其外周血单个核细胞TLR4表达的变化[J]. 实用肝脏病杂志, 2017, 20(6): 728-731.

Chen Guangyao, Han Ji’ao, Zhou Dongxiao. Small intestinal bacterial overgrowth and TLR4 expression on the surface of peripheral blood mononuclear cells in patients with liver cirrhosis[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2017, 20(6): 728-731.

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