本文選題：內(nèi)毒素 + 肝硬化　； 參考：《寧夏醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的通過對慢性肝炎及肝硬化患者血清內(nèi)毒素及肝功能相關(guān)指標(biāo)的檢測，探討血清內(nèi)毒素定量水平與肝硬化Child-pugh分級的關(guān)系。為微生態(tài)制劑對肝硬化的影響提供臨床佐證。 方法以2012年1月至2013年6月寧夏醫(yī)科大學(xué)總醫(yī)院感染性疾病科收住的慢性肝炎及肝硬化患者為研究對象。其中慢性肝炎（中度）組20例，肝硬化組96例。肝硬化組隨機(jī)分為對照組25例，實(shí)驗(yàn)組71例。實(shí)驗(yàn)組按Child-pugh分級分為A級26例、B級24例、C級21例。各組均給予常規(guī)治療。肝硬化實(shí)驗(yàn)組給予口服微生態(tài)制劑—雙歧桿菌乳桿菌三聯(lián)活菌片（金雙歧）治療8周，檢測各組患者血清內(nèi)毒素定量。與對照組比較、肝硬化實(shí)驗(yàn)組隨著Child-Pugh評分分級的增加、血清中的內(nèi)毒素水平逐漸增加，與Child-pugh分級呈明顯的相關(guān)性，實(shí)驗(yàn)組治療后血清內(nèi)毒素水平顯著降低。 結(jié)果與慢性肝炎組比較：肝硬化組內(nèi)毒素水平慢性肝炎組（P0.05、有統(tǒng)計學(xué)意義）。實(shí)驗(yàn)組予以口服藥物金雙歧維持治療8周后、血清內(nèi)毒素水平較治療前明顯改善（P0.05、有統(tǒng)計學(xué)意義）。肝硬化實(shí)驗(yàn)組：隨著肝硬化Child-Pugh分級評分的增加，血清中內(nèi)毒素水平及總膽紅素定量逐漸增高，白蛋白逐漸下降，凝血酶原時間逐漸延長。血清內(nèi)毒素、肝功能指標(biāo)（PT、TB、ALB）水平較治療前具有統(tǒng)計學(xué)意義(P0.05)，與對照組相比差異具有統(tǒng)計學(xué)意義(P0.05)。Spearman’s相關(guān)性分析顯示，血清內(nèi)毒素水平與Child-PughA、B、C分級存在在直線正相關(guān)性（r=0.906，P0.05）；血清內(nèi)毒素與血清凝血酶原時間、總膽紅素與白蛋白均存在直線相關(guān)性。 結(jié)論肝硬化組內(nèi)毒素水平慢性肝炎組。隨著肝硬化Child-Pugh分級評分的增加，患者血清中內(nèi)毒素及總膽紅素定量增加，，凝血酶原時間延長，白蛋白下降，在肝硬化不同Child-Pugh分級中存在明顯差異；血清內(nèi)毒素水平、總膽紅素定量、凝血酶原時間及白蛋白與Child-Pugh評分有直線相關(guān)性，內(nèi)毒素對Child-Pugh評分有明顯的影響作用，對判斷肝臟疾病嚴(yán)重程度有重要的參考依據(jù)，也為微生態(tài)制劑對肝硬化的影響提供臨床佐證。
[Abstract]:Objective to investigate the relationship between serum endotoxin and Child-pugh grade in patients with chronic hepatitis and cirrhosis.To provide clinical evidence for the effect of microecological preparation on liver cirrhosis.Methods from January 2012 to June 2013, patients with chronic hepatitis and cirrhosis received from infectious diseases department of Ningxia Medical University General Hospital were studied.There were 20 cases of chronic hepatitis (moderate) group and 96 cases of cirrhosis group.The cirrhosis group was randomly divided into control group (n = 25) and experimental group (n = 71).According to Child-pugh classification, the experimental group was divided into 26 cases of grade A, 24 cases of grade B and 21 cases of grade C.All groups were given routine treatment.The experimental group of liver cirrhosis was treated with oral bifidobacterium bifidobacterium triplex bifidobacterium tablet for 8 weeks, and the serum endotoxin was measured.Compared with the control group, the level of serum endotoxin in the experimental group of liver cirrhosis increased gradually with the increase of Child-Pugh score, and was significantly correlated with the Child-pugh grade. The level of serum endotoxin in the experimental group decreased significantly after treatment.Results compared with chronic hepatitis group, the level of endotoxin in liver cirrhosis group was significantly higher than that in chronic hepatitis group (P 0.05).After 8 weeks of oral administration of gold bifidus, the serum endotoxin level in the experimental group was significantly improved than that before treatment (P 0.05).Experimental group of liver cirrhosis: with the increase of Child-Pugh grade of cirrhosis, the level of endotoxin in serum and the quantity of total bilirubin increased gradually, albumin decreased gradually and prothrombin time was prolonged gradually.The levels of serum endotoxin and liver function were significantly higher than those before treatment (P 0.05), and the correlation analysis showed that compared with the control group, the levels of serum endotoxin and liver function were significantly higher than those of the control group.The level of serum endotoxin was positively correlated with Child-Pugh Agna BU C grade, and there was a linear correlation between serum endotoxin and serum prothrombin time, total bilirubin and albumin.Conclusion the level of endotoxin in cirrhosis group was higher than that in chronic hepatitis group.The serum endotoxin and total bilirubin were increased, prothrombin time prolonged and albumin decreased with the increase of liver cirrhosis Child-Pugh grading.Total bilirubin quantification, prothrombin time and albumin have linear correlation with Child-Pugh score, endotoxin has obvious effect on Child-Pugh score, which has important reference basis for judging the severity of liver disease.It also provides clinical evidence for the effect of microecological preparation on liver cirrhosis.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R575.2

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