摘要
目的恶性肿瘤与放疗化疗对血中内毒素影响国内尚无报导。现用改进的鲨试验方法对肿瘤病人血中内毒素水平进行研究。方法用稀释加热法处理后的健康人血浆代替单纯无热原水，稀释内毒素制定标准曲线。65例健康人测定正常值，作为对照。44例病理确诊的恶性肿瘤病人参加本研究。病人分成两组（未治疗组21例，治疗组23例），诊断相似。治疗前和治疗后4周内采血，测定内毒素值。数据用StatViewSE软件作统计分析，P＜0．05时差异有显著性。结果用无热原水和用血浆制定的内毒素标难曲线有差别（截距为2），灵敏度可达到微微克（Pg）水平。65例健康人内毒素正常值为4．90±0．79Pg／ml。恶性肿瘤患者外周血内毒素高于健康人（4．83±0．70Pg／ml，P＝0．03）。放疗化疗后明显升高（6．58±3．04Pg／ml：4．80±0．68Pg／ml，P=0．03），并且内毒素异常阳性率差异有显著性（7．8％：8．7％，P=0．04）。结论研究表明恶性肿瘤和放疗化疗导致肠粘膜屏障受损，肠粘膜通透性增加导致内毒素移位。放疗化疗后部分病人合并感染可能与此关。
Purpose The impact of malignant tumor, radiotherapy and chemotherapy on plasma endotoxin level has not been reported in China. The plasma endotoxin concentration of tumor bearing patients was measured with improved method in this study. Methods Normal plasma endotoxin value was determined on 65 healthy Chinese volunteers. The standard curve of endotoxin concentration was creased by diluting endotoxin with diluting heating method prepared healthy human plasma instead of with pyrogen-free water, which made the results reflect the actual endotoxin level more accurately. Forty four pathologically diagnosed malignant tumor patients were enrolled in this study, divided into two groups (without radiotherapy /chemotherapy 21 cases, with radiotherapy/chemotherapy 23 cases) having similardiagnosis. Blood was sampled for endotoxin measurement before treatment and 4 weeks after treatment. Statistical analysis was done with 'Stat View SE for Micintosh', significant difference was considered when P < 0.05. Results The standard curve of endotoxin concentration determine by pyrogen-free water diluted endotoxin was different from that by plasma diluted. The sensitivity of the method in this study reached level of pictogram (Pg.). The normal endotoxin concentration of 65 hedthy Chinere was 4. 09 ±0. 79Pg/ml. The peripheral endotoxin level of malignant tumor patients were higher (4. 83 ±0. 70pg/ml) then that of hedthy Volunteers (P = 0. 03). Sighficant increase of peripheral endotoxin level in patients after radiotheraphy and chemotherapy (6. 58±3. 04Pg/ml, P = 0.03;4. 80±0. 68pg/ml, P = 0. 03) was noiced with the positive rate of patients having elevated endotoxin of 47. 8% and 8. 7% respectively. Conclusions Our study implied that malignant tumor, radiotherapy /chemotherapy might impair gut mucosal barrier. The increased of intestinal mucosal permeability could result in endotoxin translocation, which mihght be associated with the infectious complication in part of the patients after radiotherapy/chemotherapy.
出处
《中国临床营养杂志》
1999年第4期183-183,共1页
Chinese Journal of Clinical Nutrition
基金
卫生部重点项目!9701024
博士点基金!9806
