人胆汁中的未结合胆红素：胆固醇性胆结石的成核因子？
Unconjugated bilirubin in human bile: the nucleating factor in cholesterol cholelithiasis?
作者信息
Dutt M K, Murphy G M, Thompson R P H
机构信息
Gastrointestinal Laboratory, The Rayne Institute, St Thomas's Hospital, London SE1 7EH, UK.
出版信息
J Clin Pathol. 2003 Aug;56(8):596-8. doi: 10.1136/jcp.56.8.596.
AIMS
To investigate the concentrations of bilirubin, bilirubin conjugates, phospholipid, and cholesterol in the gall bladder bile obtained at surgery from patients with and without cholesterol gallstones.
METHODS
Gall bladder bile was collected during surgery, by puncture, from 20 patients with gallstones undergoing routine cholecystectomy and from eight patients with normal liver blood tests. Concentrations of bilirubin, bilirubin conjugates, phospholipid, and cholesterol were measured using standard procedures.
RESULTS
The proportion of total bilirubin that was unconjugated was significantly higher in the bile from patients with stones than in bile from control patients, whether or not the bile from either group was saturated with cholesterol or not. Indeed, the mean concentration of cholesterol was significantly higher in control bile samples.
CONCLUSION
The presence of stones was more closely related to the proportion of unconjugated bilirubin than to the degree of saturation of bile with cholesterol. Bilirubin and its metabolites probably play an important part in the formation of cholesterol gallstones.
目的
研究有或无胆固醇胆结石患者手术时获取的胆囊胆汁中胆红素、胆红素结合物、磷脂和胆固醇的浓度。
方法
通过穿刺在手术期间从20例行常规胆囊切除术的胆结石患者以及8例肝功能血液检查正常的患者中收集胆囊胆汁。使用标准程序测量胆红素、胆红素结合物、磷脂和胆固醇的浓度。
结果
无论两组胆汁是否被胆固醇饱和，结石患者胆汁中未结合胆红素占总胆红素的比例均显著高于对照患者的胆汁。实际上，对照胆汁样本中胆固醇的平均浓度显著更高。
结论
结石的存在与未结合胆红素的比例关系更为密切，而非与胆汁中胆固醇的饱和程度相关。胆红素及其代谢产物可能在胆固醇胆结石的形成中起重要作用。
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