慢性重型肝炎患者血清内毒素调节蛋白的水平及其临床意义

To explore the changes of blood levels of Lipopolysaccharide (LPS) ?Lipopolysaccharide-binding protein (LBP) ?bactericidal / permeability-increasing protein? (BPI) ?soluble CD14 (sCD14) and their clinical significance in patients with chronic severe viral hepatitis B. The blood levels of LPS were detected with chromogenic limulus amebocyte lysate assay and LBP?BPI and sCD14 were detected with ELISA in 24 patients of chronic severe viral hepatitis B while 10 normal subjects and 16 patients with chronic hepatitis B were used as controls. The blood levels of LPS?LBP?BPI and sCD14 were significantly higher than in patients with the early stage?midterm?later period of chronic severe viral hepatitis B than in normal subjects. and those with chronic hepatitis B. The blood levels of LPS?LBP?BPI and sCD14 were also significantly higher in patients who died of chronic severe viral hepatitis B than in chronic severe viral hepatitis B survivors. So higher LBP?LPS and relative deficiency of BPI levels in patients with chronic severe viral hepatitis B accompanied by Intestinal endotoxemia (IETM) may significantly increase the sensitivity of body to endotoxin. administration of monoclonal anti-LBP antibody?monoclonal anti-CD14 antibody and the recombinant BPI is effective in attenuating LPS to hepatocyte injury.