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首页> 外文期刊>Hepatology: Official Journal of the American Association for the Study of Liver Diseases >Bacterial DNA translocation is associated with systemic circulatory abnormalities and intrahepatic endothelial dysfunction in patients with cirrhosis.
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Bacterial DNA translocation is associated with systemic circulatory abnormalities and intrahepatic endothelial dysfunction in patients with cirrhosis.

机译：肝硬化患者细菌DNA易位与全身循环异常和肝内内皮功能障碍有关。

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Presence of bacterial DNA in noninfected patients with cirrhosis and ascites is associated with a marked inflammatory response including activation of the inducible form of nitric oxide synthase and release of nitric oxide, similar to that observed in patients with spontaneous bacterial peritonitis. Although presence of bacterial DNA is associated with an impaired prognosis, no information is available regarding its hemodynamic consequences. Systemic and hepatic hemodynamics before and after a liquid test meal were assessed in a series of 75 noninfected patients with cirrhosis (55 with ascites). Bacterial DNA was measured by polymerase chain reaction. Bacterial DNA was detected only in patients with ascites. Clinical data and liver function were similar in ascitic patients with presence (n = 21) or absence of bacterial DNA (n = 34). Bacterial-DNA(+) patients had significantly lower mean arterial pressure (P = 0.002) and systemic vascular resistance (P = 0.03) than bacterial-DNA(-) patients. Cardiac output, cardiopulmonary pressures, hepatic venous pressure gradient (HVPG), and hepatic blood flow were similar in both groups. Thirty minutes after the test meal, in response to increased blood flow caused by postprandial hyperemia, there was a significantly greater increase in HVPG and impaired hepatic vasorelaxation in bacterial-DNA(+) as compared with bacterial-DNA(-) patients, which indicates hepatic endothelial dysfunction. Indeed, the increase in HVPG after the test meal significantly correlated with serum bacterial DNA concentration. Conclusion: Presence of bacterial DNA, a marker of bacterial translocation, is associated with aggravation of peripheral vasodilation and with worsening of intrahepatic endothelial dysfunction.
机译：未感染的肝硬化和腹水患者中细菌DNA的存在与明显的炎症反应有关，包括激活可诱导形式的一氧化氮合酶并释放一氧化氮，这与自发性细菌性腹膜炎患者相似。尽管细菌DNA的存在与预后不良有关，但尚无有关其血液动力学后果的信息。在一系列75例未感染的肝硬化患者（55例有腹水）中评估了液体测试餐前后的全身和肝脏血液动力学。通过聚合酶链反应测量细菌DNA。仅在腹水患者中检测到细菌DNA。有腹水（n = 21）或无细菌DNA（n = 34）的腹水患者的临床数据和肝功能相似。与细菌DNA（-）患者相比，细菌-DNA（+）患者的平均动脉压（P = 0.002）和全身血管阻力（P = 0.03）明显更低。两组的心输出量，心肺压力，肝静脉压力梯度（HVPG）和肝血流量相似。测试餐后30分钟，由于餐后充血引起的血流量增加，与细菌DNA（-）患者相比，细菌DNA（+）患者的HVPG升高和肝血管舒张受损明显更大，这表明肝内皮功能障碍。实际上，测试餐后HVPG的增加与血清细菌DNA浓度显着相关。结论：细菌DNA（细菌易位的标志物）的存在与外周血管舒张加重和肝内内皮功能障碍的恶化有关。

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