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Lingnan Modern Clinics in Surgery ›› 2017, Vol. 17 ›› Issue (04): 400-403.DOI: 10.3969/j.issn.1009-976X.2017.04.005

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Clinical significances of plasma diamineoxidase,D-lactate and endotoxin activity in critical ill patient with gastrointestinal dysfunction

HE Zhijie, ZHI Yaowei, HUANG Chaotai, ZHOU Minggen, ZOU Zijun, LI Weichao   

  1. 1 Department of Critical Care Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China. 2 Department of Critical Care Medicine, the People’s Hospital of Fuzhou, Jiangxi 344000, China.

血清二胺氧化酶、D-乳酸和细菌内毒素在重症患者肠道功能评估中的作用

何志捷 植耀炜 黄超泰 周明根 邹子俊 李伟超   

  1. 中山大学孙逸仙纪念医院重症医学科
  • 通讯作者: 何志捷

Abstract:

Objective To investigate the value of diamineoxidase, D-lactic and endotoxin in critical illness with gastrointestinal dysfunction. Methods  117 patients admitted to ICU were quantitatively detected serum diamineoxidase, D-lactic and endotoxin by using diamineoxidase/lactic/ endotoxin inspection Kit, and calculated the first 24 h Acute Physiology And Chronic Health Evaluation APACHE . The gastrointestinal function of patients was evaluated firstly, and according to whether patients presented gastrointestinal dysfunction, 117 patients were assigned to two group:non-gastrointestinal dysfunction group and gastrointestinal dysfunction group. Results Plasma diamineoxidase level were markedly increased in gastrointestinal dysfunction group16.46±22.60 U/Las compare with non-gastrointestinal dysfunction group6.33 ± 9.55 U/L, P=0.01. Serum D-lactate levels were markedly increased in gastrointestinal dysfunction group24.32 ± 16.49mg/Las compare with non-gastrointestinal dysfunction group11.66±12.36 mg/L, P<0.01. Serum endotoxin levels were higher in gastrointestinal dysfunction group 11.43 ± 9.70U/L than in non-gastrointestinal dysfunction group 9.34 ± 0.17 U/L, P=0.04 Diamineoxidase, D-lactic and endotoxin levels were positively correlated with APACHE II scores:r=0.427, P=0.01, r=0.53, P<0.001, and r=0.451, P<0.001, respectively. Conclusion Diamineoxidase, D-lactic and endotoxin levels were significant increasing in patients with severe gastrointestinal dysfunction and were positively correlated with APACHE and II scores. It suggests the serum diamineoxidase, D-lactic and endotoxin can be used to evaluate gastrointestinal dysfunction as well as the severity in critically ill patients.

Key words: diamineoxidase, D-lactate, endotoxin, ICU

摘要:

目的 探讨血清二胺氧化酶(DAO)、D-乳酸(DLC)和细菌内毒素(BT)水平在ICU重症患者中的变化及其在肠道功能和病情评估中的临床意义。方法 117例患者在入科24小时内进行APACHE评分,采用二胺氧化酶/乳酸/细菌内毒素联检试剂盒(酶法)定量检测人体血清中二胺氧化酶、D-乳酸和细菌内毒素的活性,分析ICU重症患者二胺氧化酶、D-乳酸和细菌内毒素的变化及其与APACHE评分的关系。结果 根据患者是否存在胃肠功能障碍将ICU重症患者分为非胃肠功能障碍组和胃肠功能障碍组。非胃肠功能障碍组与胃肠功能障碍组的血清二胺氧化酶水平分别为6.33±9.55U/L16.46±22.60U/L,两组比较,差异有统计学意义(P=0.01),D-乳酸水平分别为11.66±12.36mg/L24.32±16.49mg/L,两组比较,差异有统计学意义(P<0.001),细菌内毒素水平分别为9.34±10.17U/L11.43±9.70U/L,两组比较,差异有统计学意义(P=0.04);患者二胺氧化酶、D-乳酸、细菌内毒素水平和APACHEII评分呈显著正相关,二胺氧化酶与APACHEII评分:r=0.427P=0.01D-乳酸与APACHE评分:r=0.53P<0.001,细菌内毒素水平与APACHEII评分:r=0.451P<0.001结论 ICU胃肠功能障碍的重症患者血清二胺氧化酶、D-乳酸和细菌内毒素水平显著升高,二胺氧化酶、D-乳酸、细菌内毒素水平和患者APACHEII评分呈显著正相关。监测血二胺氧化酶、D-乳酸和细菌内毒素活性可作为评估ICU重症患者胃肠功能障碍的重要指标及评估病情严重程度的指标之一。

关键词: 二胺氧化酶, 细菌内毒素, D-乳酸, 危重症

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