The Influnce Of Transjugular Intrahepatic Portosystemic Shunts (TIPS) And Modified Sugiura Operation (MSO) On Systemic Inflammatory Response And Intestinal Biological Barrier

Objective:To explore the different effects to systemic inflammatory response and intestinal biological barrier,by observing the influnces of transjugular intrahepatic portosystemic shunts and modified sugiura oparation on inflammatory mediators,cytokines and intestinal bacterial community.Methods:Serum got from portal vein,hepatic vein and inferior vena cava in 22 TIPS patients and 10 MSO patients,respectively.All the serum is taken before the sugery/Interventional and after 1 week.TNF-?,IL-1?and IL-6 levels are detected in ELISA way while NO and MDA levels are detected in nitrate reductase method and TBA method respectively.The alternation of intestinal bacterial community between Preoperative and a month after sugery/Interventional is detected by denaturing gradient gel electrophoresis(DGGE).Result:The portal pressure decreased significantly both in TIPS group and MSO group(P<0.05).In TIPS group,no significant change was found in inflammatory mediators and MDA level(p>0.05).In MSO group,inflammatory mediators and MDA level was increased significantly after operation(P<0.05).Among two groups,NO level was obviously decreased in portal vein and hepatic vein(P<0.05).The amount of intestinal bacterial community is significantly decreased in both groups(P<0.05).Conclusion:The portal pressure can be effectively reduced by TIPS and MSO.The function of intestinal biological barrier can be improved by both surgery.TIPS,as a minimally invasive treatment,won't aggravate the systemic and local inflammatory reaction and Immunological stress.MSO,compaired with TIPS,has more severe trauma,will increase the systemic and local inflammatory reaction and immune stress in the short term.