Nishida T, Nakahara M, Nakao K, Matsuda H
First Department of Surgery, Osaka University Medical School, Osaka Police Hospital, Suita, Japan.
Am J Surg. 1999 Jan;177(1):38-41. doi: 10.1016/s0002-9610(98)00291-8.
Bacterial cholangitis is frequently associated with serious complications.
The plasma disappearance rates and the biliary output of bile acids and bilirubin after percutaneous transhepatic biliary drainage (PTBD) were examined in 29 patients with extrahepatic biliary obstruction.
Twenty-nine patients were divided into the bacteria-minus (n = 17) and bacteria-plus (n = 12) groups. Decreases in the plasma bile acid and bilirubin levels of the bacteria-minus group (t1/2 = 0.38 and 3.8 days for bile acids and bilirubin, respectively) were faster than those of the bacteria-plus group (t1/2 = 1.7 and 7.5 days). The bile flow rate was significantly increased in the bacteria-plus group compared with the bacteria-minus group. The calculated values of bilirubin and bile acid in the bile were higher in the bacteria-minus group than in the bacteria-plus group.
Bacterial colonization in the bile stimulates bile duct cells to increase bile volume and inhibits the hepatocyte transport activity of bile acids and bilirubin.
细菌性胆管炎常伴有严重并发症。
对29例肝外胆管梗阻患者进行经皮经肝胆道引流（PTBD）后，检测血浆中胆汁酸和胆红素的清除率以及胆汁的分泌量。
29例患者分为无细菌组（n = 17）和有细菌组（n = 12）。无细菌组血浆胆汁酸和胆红素水平的下降速度（胆汁酸和胆红素的t1/2分别为0.38天和3.8天）比有细菌组（t1/2分别为1.7天和7.5天）更快。与无细菌组相比，有细菌组的胆汁流速显著增加。无细菌组胆汁中胆红素和胆汁酸的计算值高于有细菌组。
胆汁中的细菌定植刺激胆管细胞增加胆汁量，并抑制肝细胞对胆汁酸和胆红素的转运活性。
