腸管および腹腔内からのエンドトキシンの侵入経路に関する臨床的検討  [in Japanese] A CLINICAL STUDY ON TRANSLOCATION OF ENTERIC AND INTRAABDOMINAL ENDOTOXIN INTO THE CIRCULATION  [in Japanese]

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Abstract

腹膜炎症例におけるbacterial translocationについて検討した.腹膜炎症例17例を対象として手術前後に末梢血を採取し,エンドトキシン(以下Et)およびβ-グルカン(以下G)を測定した.なお,測定はエンドスペシー,トキシカラー(ともに生化学工業)を用いた.術前のEtは3.3±2.0(pg/ml,平均±標準偏差)でその後もほぼ一定の値で経過し,陽性となった症例は認められなかった. G値は第1病日にやや上昇するもののその後まもなく術前値に復した.次に,消化管穿孔症例14例の術後第1, 3病日における腹水および末梢血中Etを比較検討した.腹水中Etは第1病日514.4±251.3,第3病日158.0±210.5と第1病日で有意(p<0.05)に高値を示したが,一方,末梢血中Etは1.8±2.1, 2.0±2.1にとどまった.以上の結果,腹腔内に数百pg/mlのEtが認められる腹膜炎の状態でも末梢血には影響しないことが示され,術後第7病日まではbacterial translocationの存在は否定的であった.

We studied postoperative changes in the bacterial translocation in 17 patients with peritonitis. Blood was taken before the operation and postoperative days (POD), and also endotoxin (Et) and β-glucan (G) were measured by using quantitative Limulus assay. The preoperative Et levels were 3.3±2.0 (pg/ml, mean±SD), these levels showing minimal changes within a similar range. The G levels slightly increased on the 1 POD, but decreased thereafter. Then Et levels were compared with ascites and peripheral blood in 14 patients with perforated digestive disorders on the 1 and 3 POD. The Et levels on the 1 POD in ascites (514.4±251.3) were significantly higher than those on the 3 POD (158.0±210.5 p<0.05). On the other hand, the Et levels in peripheral blood were 1.8±2.1 and 2.0±2.1 respectively. These findings suggest that Et levels as a few hundred pg/ml in the ascites does not involve peripheral endotoxemia in patients with peritonitis due to perforated digestive disorders, and bacterial translocation would not be observed till the 7 POD.

Journal

  • The journal of the Japanese Practical Surgeon Society

    The journal of the Japanese Practical Surgeon Society 57(7), 1529-1534, 1996-07-25

    Japan Surgical Association

References:  22

Cited by:  1

Codes

  • NII Article ID (NAID)
    10008522345
  • NII NACSIS-CAT ID (NCID)
    AN00198696
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03869776
  • Data Source
    CJP  CJPref  J-STAGE 
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