"Endotoxin in ascitic fluid of liver cirrhosis in man"

概要

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Endotoxin was studied by Limulus lysate test about ascites and plasma of the 20 cirrhotics with both ascites and esophageal varices, and about plasma of the 16 control cirrhotics with esophageal varices only.Endotoxin was positive in 16 (80.0%) of the ascitic fluid and 13 (65.0%) of the plasma in the cirrhotics with ascites. In contrast, endotoxemia was found in only 18.8% (3 of 16) of the control patients The incidence of endotoxemia in the ascitic group (65.0%) was significantly larger than that of the ascitic free control group (P<0.025). Eleven of the 20 (55.0%) ascitic fluid showed high concentiations of endotoxin above 10-3μg/ml. Considering ascites is continuously circulating, it is natural to conclude that endotoxin mainly comes into the systemic circulation from the ascitic fluid in the cirrhotics, although the factors of the loss of capacity to detoxify intestinal endotoxins and the internal and external shunt must be taken into consideration.As to the biologic actions of endotoxin, no cases with endotoxemia showed hypotension, and only one case showed fever above 37.5°C, and the occurrence of endotoxin tolerance was suspected.
財団法人日本消化器病学会の論文