[1]张慧力,张同琳.胆囊胆固醇息肉与胆固醇结石的胆汁成分比较[J].中国微创外科杂志,2008,08(8):745-751.
　Zhang Huili,Zhang Tonglin..Comparison of Biliary Composition between Cholesterol Polyps and Cholesterol Gallstones Patients[J].Chinese Journal of Minimally Invasive Surgery,2008,08(8):745-751.
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胆囊胆固醇息肉与胆固醇结石的胆汁成分比较()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
08
期数:
2008年8期
页码:
745-751
栏目:
出版日期:
2008-11-02

文章信息/Info

Title:
Comparison of Biliary Composition between Cholesterol Polyps and Cholesterol Gallstones Patients
作者:
张慧力; 张同琳
北京大学第三医院普外科，北京100191
Author(s):
Zhang Huili;  Zhang Tonglin.
Department of General Surgery, Peking University Third Hospital, Beijing 100191, China
关键词:
胆固醇息肉; 胆固醇结石; 胆汁成分
Keywords:
Cholesterol polyps; Cholesterol gallstones; Bile ingredients
分类号:
R657.4
文献标志码:
A
摘要:
目的分析胆囊胆固醇结石与胆固醇息肉病人的胆囊胆汁成分，探讨胆固醇结石和胆固醇息肉形成中各种成分的差异。方法测定20例胆囊胆固醇息肉（息肉组）、20例胆囊胆固醇结石（结石组）和10例非肝胆疾病（对照组）的胆囊胆汁成分。采用HITACHI7060 全自动生化分析仪测定总胆汁酸（TBA）、磷脂（PL）和总胆固醇(TC)；氨基己糖比色法测定糖蛋白；ORION720A型数字离子酸度计测定游离Ca2+浓度及pH值；Agilent1100高效液相色谱分析仪测定8种结合胆汁酸的含量。结果息肉组和结石组TC［(14.0±0.5)mmol/L,(18.6±1.2)mmol/L］、CSI（1.217±0.039，1.565±0.087）、三羟/二羟胆汁酸比值（0.702±0.084，0.763±0.060）均显著高于对照组TC(9.1±0.8)mmol/L、CSI(0.812±0.075)、三羟/二羟胆汁酸比值(0.585±0.067)(P<0.05)，而且上述指标结石组显著高于息肉组(P<0.05)。2组TBA含量分别为（110.7±14.8）mmol/L、（105.8±16.5）mmol/L，显著低于对照组（137.6±33.1）mmol/L (P<0.05)。结石组糖蛋白（1.8±0.2）mmol/L、游离Ca2+（2.2±0.3）mmol/L及pH值(7.9±0.3)显著高于息肉组和对照组糖蛋白（0.6±0.1）mmol/L，（0.7±01）mmol/L、游离Ca2+（1.2±0.2）mmol/L，（1.1±0.1）mmol/L、pH值（7.0±0.1），(6.9±0.2）（P<0.05）。结石组甘氨胆酸(G)/牛磺胆酸(T)比值（2.777±0.217）显著低于息肉组（3.624±0.465）和对照组（3.960±0.377）（P<0.05）；结石组和息肉组PL/ TBA（0.311±0.044，0292±0036）显著高于对照组（0.241±0.082）(P<0.05)。结论胆囊胆汁中总胆汁酸含量的降低和总胆固醇浓度的升高，是形成胆固醇结石和胆固醇息肉的共同因素。结合胆汁酸构成比例、pH值、糖蛋白及游离钙离子浓度在胆囊胆固醇息肉及结石的胆汁中存在差别。
Abstract:
ObjectiveTo investigate the difference in biliary composition between cholesterol polyps and cholesterol gallstones patients.MethodsTotally 20 patients with cholesterol polyps (CP group), 20 cases of cholesterol gallstones (CG group), and 10 adults without hepatobiliary diseases (control) were enrolled in this study. HITACHI-7060 automatic biochemistry analyzer was employed to determine the concentration of total bile acid (TBA), phospholipid (PL), and total cholesterol (TC) of the patients. Glycoprotein was detected by colorimetric method. Free Ca2+ and pH value were anlyzed using ORION-720A ionic acidimeter. And the contents of 8 conjugated bile acids in gallbladder bile were determined by using Agilent-1100 high performance liquid chromatography. ResultsThe conentration of TC, cholesterol saturation index (CSI), and the ratio of (TCA+GCA)/(TCDCA+GCDCA+GDCA+TDCA) of the CP and CG groups were significantly higher than those of the control ［TC: (14.0±0.5) mmol/L and (18.6±1.2) mmol/L vs (9.1±0.8)mmol/L, P＜0.05; CSI: 1.217±0.039 and 1.565±0.087 vs 0.812±0075, P＜0.05; ratio of (TCA+GCA)/(TCDCA+GCDCA+GDCA+TDCA): 0.702±0.084 and 0.763±0.060 vs 0.585±0.067, P<0.05］. Moreover, the data of the CG group was significantly higher than those of the CP group (P<0.05). The level of TBA in the CG and CP groups was significantly lower than that in the control ［(110.7±14.8) mmol/L and (105.8±16.5) mmol/L vs (137.6±33.1) mmol/L, P<0.05］. Whereas, the concentration of glycoprotein and free Ca2+, and pH value of the CG group were significantly higher than those in the other two groups ［glycoprotein: (1.8±0.2) mmol/L vs (0.6±0.1) mmol/L and (0.7±0.1) mmol/L; free Ca2+: （2.2±0.3）mmol/L vs (1.2±0.2) mmol/L and (1.1±0.1) mmol/L; pH: 7.9±0.3 vs 7.0±0.1 and 6.9±0.2; all P<0.05］. The ratio of G/T in the CG group was significanlty lower than that in the CP and control groups (2.777±0217 vs 3.624±0.465 and 3.960±0.377; P<0.05), however, the ratio of PL/TBA in CP and CG groups was significantly higher than that of the control (0.311±0.044 and 0292±0036 vs 0.241±0.082, P<0.05).ConclusionsBoth decreased TBA and increased TC play a role in the formation of cholesterol polyps and cholesterol gallstones. The content of conjugated bile acids, glycoprotein, free Ca2+, and pH value in patients with cholesterol polyps are different from those in cholesterol gallstones cases.

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更新日期/Last Update: 2013-10-23