鹅去氧胆酸治疗期间胆固醇结石患者中石胆酸硫酸化增加。

Increased sulfation of lithocholate in patients with cholesterol gallstones during chenodeoxycholate treatment.

作者信息

Stiehl A, Raedsch R, Kommerell B

出版信息

Digestion. 1975;12(2):105-10. doi: 10.1159/000197660.

DOI:10.1159/000197660

Abstract

Chenodeoxycholate was administered to 13 patients with cholesterol gallstones. During the treatment period the bile composition changed markedly. Chenodeoxycholate increased from 42.9% of the total bile salts before treatment to 79.3% after 8 weeks of treatments. Ursodeoxycholate increased from 2.3 to 12.6% and lithocholate from 1.1 to 3.3%. In contrast, cholate decreased from 40.3% of the total bile salts to 3.1% and deoxycholate decreased from 12.5 to 2.5%. Less than 5% of chenodeoxycholate, ursodeoxycholate, cholate and deoxycholate in bile were sulfate esters. In contrast, considerable amounts of lithocholate were sulfated. The sulfation of lithocholate increased from 32.8% of the total lithocholate before treatment to 73.9% after 8 weeks of treatment. Sulfated lithocholate is more rapidly eliminated in feces and urine than the nonsulfated compound. Furthermore, sulfated lithocholate is less toxic. Therefore, the increase in the sulfation of lithocholate observed in most of our patients represents a protective mechanism.

摘要

对13例胆固醇结石患者给予鹅去氧胆酸治疗。治疗期间胆汁成分发生显著变化。鹅去氧胆酸在治疗前占总胆汁盐的42.9%，治疗8周后增至79.3%。熊去氧胆酸从2.3%增至12.6%，石胆酸从1.1%增至3.3%。相比之下，胆酸从总胆汁盐的40.3%降至3.1%，脱氧胆酸从12.5%降至2.5%。胆汁中鹅去氧胆酸、熊去氧胆酸、胆酸和脱氧胆酸的硫酸酯不到5%。相比之下，相当数量的石胆酸被硫酸化。石胆酸的硫酸化率从治疗前占总石胆酸的32.8%增至治疗8周后的73.9%。硫酸化石胆酸比未硫酸化的化合物在粪便和尿液中消除得更快。此外，硫酸化石胆酸毒性较小。因此，在我们大多数患者中观察到的石胆酸硫酸化增加代表一种保护机制。