目的 探討選擇性消化道滅菌(SDD)對腸源性內毒素血癥的預防作用。方法 Wistar大鼠60只，胰管逆行灌注法復制急性壞死性胰腺炎(ANP)模型，設立正常對照組、假手術組、ANP組和SDD治療組(ANP后喂服三聯(lián)抗生素)，記錄發(fā)病72小時組織學、血清TNFα、IL-1β、腸道菌群、血漿D-乳酸(腸通透性指標)和內毒素含量及病死率。 結果 SDD使ANP胰腺和小腸病理改變減輕，TNFα水平下降(P＜0.01)。ANP時腸道大腸桿菌等條件致病菌過度繁殖，雙歧桿菌數(shù)量減少，SDD抑制了致病菌的繁殖，雙歧桿菌數(shù)量不變，雙歧桿菌/大腸桿菌比值(B/E值)回升(P＜0.01)。SDD組血漿D-乳酸由(8.05±3.05) mg/L降至(3.95±1.83) mg/L(P＜0.01)，門靜脈內毒素由(0.423±0.155) EU/ml下降至(0.227±0.084) EU/ml(P＜0.01)。ANP組72小時病死率為58.8%，SDD組為14.3%(P＝0.005)。結論 SDD可減少腸道革蘭氏陰性菌含量，保護正常菌群，維護腸屏障，減輕了ANP時腸源性內毒素血癥，有助于提高ANP的生存率。
引用本文： 鄧群,黎沾良,熊德鑫. 選擇性消化道滅菌對急性胰腺炎腸源性內毒素血癥的預防作用. 中國普外基礎與臨床雜志, 2001, 8(6): 361-363下轉366. doi: 復制
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