Lindblad L, Hammarsten J, Scherstén T
Scand J Gastroenterol. 1975;10(6):633-9.
In order to elucidate the relationship between bile acid secretion and the secretion of lecithin and cholesterol in the postcholestatic condition, five patients were studied after release of complete biliary obstruction. Ten patients operated on for uncomplicated gallstone disease served as controls. The secretion of bile acids, which constituted only newly synthesized acids, increased in the postcholestatic period 2.5-22 times. In spite of that the secretion rate of bile acids was low (less than or equal to 7.5 mumol x min-1). The pattern of the relationships between bile acid secretion and bile flow and bile acid secretion and lecithin and cholesterol secretion was the same in the postcholestatic patients as in the controls. However, the bile flow showed a higher bile acid dependency in the postcholestatic condition, and the bile-acid-independent flow varied considerably in these patients as compared with controls. Linear relations between the secretion rate of bile acids and lecithin and cholesterol secretion rates were found. Extrapolation to zero bile secretion revealed Y-intercepts, which were not statistically significantly different from origo. Calculations of bile acid - lecithin and bile acid - cholesterol relations in the controls at correspondingly low bile acid secretion rates (less than or equal to 5 mumol x min-1) gave results similar to those in the study group. The bile was supersaturated with cholesterol in all the postcholestatic patients similar to the condition in the controls at correspondingly low bile acid secretion rates. It is concluded that the bile acids are determinative for the biliary secretion of cholesterol and lecithin even at very low bile acid secretion rates. This conclusion was valid in patients with presumably normal liver function as well as in the early phase after release of severe cholestasis.
为了阐明胆汁淤积解除后胆汁酸分泌与卵磷脂和胆固醇分泌之间的关系，对5例完全性胆道梗阻解除后的患者进行了研究。10例因单纯性胆结石病接受手术的患者作为对照。胆汁酸的分泌仅包括新合成的酸，在胆汁淤积解除后的时期增加了2.5至22倍。尽管如此，胆汁酸的分泌率较低（小于或等于7.5 μmol·min⁻¹）。胆汁淤积解除后的患者中胆汁酸分泌与胆汁流量以及胆汁酸分泌与卵磷脂和胆固醇分泌之间的关系模式与对照组相同。然而，在胆汁淤积解除的情况下胆汁流量对胆汁酸的依赖性更高，并且与对照组相比，这些患者中不依赖胆汁酸的流量变化很大。发现胆汁酸分泌率与卵磷脂和胆固醇分泌率之间存在线性关系。外推至胆汁分泌为零时显示的Y轴截距与原点在统计学上无显著差异。在相应低胆汁酸分泌率（小于或等于5 μmol·min⁻¹）下对对照组的胆汁酸 - 卵磷脂和胆汁酸 - 胆固醇关系进行计算，得到的结果与研究组相似。所有胆汁淤积解除后的患者胆汁中胆固醇均呈过饱和状态，类似于对照组在相应低胆汁酸分泌率时的情况。得出的结论是，即使在胆汁酸分泌率非常低的情况下，胆汁酸对胆固醇和卵磷脂的胆汁分泌也具有决定性作用。这一结论在肝功能可能正常的患者以及严重胆汁淤积解除后的早期阶段均成立。
