Kurtin W E, Schwesinger W H, Diehl A K
Department of Chemistry, Trinity University, San Antonio, TX 78212, USA.
Int J Surg Investig. 2000;2(4):299-307.
The association between pigment cholelithiasis and advancing age has been previously described but little is known about the time-course of these changes.
To determine the specific changes that occur in the chemical composition of gallstones with increasing age.
Gallstones were collected from 387 non-cirrhotic patients and visually classified as either cholesterol or pigment. All stones were quantitatively analyzed by Fourier transform infrared spectroscopy for cholesterol, bilirubin, carbonate and phosphate and the results correlated with stone type and patient age.
Forty-five patients had pigment stones (12 %) and 342 had cholesterol stones (88 %). No patient had both types. There was a reciprocal relationship between the mean cholesterol and bilirubin contents of stones over time with cholesterol accounting for 54% of the weight of gallstones before age 30 and only 17% after age 70. Similarly, the mean content (by weight) of bilirubin was 35% before age 30 but 61% after age 70. In addition, the fraction of gallstones containing carbonate or phosphate salts increased sequentially with age (6% at age 30 to 57% at age 70).
(1). The ratio of pigment to cholesterol gallstones increases directly with age. (2) The cholesterol content of stones steadily decreases after age 50 while the content of bilirubin, phosphate and carbonate gradually increases. (3) These data suggest that, during aging, cholesterol may become solubilized and may be replaced by calcium salts of carbonate, phosphate or bilirubinate.
色素性胆结石与年龄增长之间的关联此前已有描述，但对于这些变化的时间进程知之甚少。
确定随着年龄增长胆结石化学成分发生的具体变化。
从387例非肝硬化患者中收集胆结石，并通过肉眼将其分类为胆固醇结石或色素结石。所有结石均采用傅里叶变换红外光谱法对胆固醇、胆红素、碳酸盐和磷酸盐进行定量分析，结果与结石类型和患者年龄相关。
45例患者有色素结石（12%），342例有胆固醇结石（88%）。没有患者同时患有这两种类型的结石。随着时间的推移，结石中胆固醇和胆红素的平均含量呈反比关系，30岁之前胆固醇占胆结石重量的54%，70岁之后仅占17%。同样，胆红素的平均含量（按重量计）在30岁之前为35%，70岁之后为61%。此外，含碳酸盐或磷酸盐的胆结石比例随年龄依次增加（30岁时为6%，70岁时为57%）。
（1）色素性胆结石与胆固醇性胆结石的比例随年龄直接增加。（2）50岁之后结石中的胆固醇含量稳步下降，而胆红素、磷酸盐和碳酸盐的含量逐渐增加。（3）这些数据表明，在衰老过程中，胆固醇可能会溶解，并可能被碳酸盐、磷酸盐或胆红素钙盐取代。
