Chijiwa K, Hirota I, Noshiro H
Department of Surgery 1, Kyushu University Faculty of Medicine, Fukuoka, Japan.
Gastroenterol Jpn. 1992 Feb;27(1):88-94. doi: 10.1007/BF02775069.
Previous studies demonstrated that higher biliary protein is associated with reduced metastability of bile. This study attempted to examine the induced effect of ursodeoxycholate on metastability of bile by measuring the nucleation time and biliary protein in cholesterol gallstone patients. Thirty-seven patients with functioning gallbladders were studied 10 control patients without gallstones and 27 with cholesterol gallstones. Ten of 27 cholesterol gallstone patients were treated with ursodeoxycholate (600 mg/day) prior to surgery. Twelve of 17 untreated gallstone patients had cholesterol crystals in gallbladder bile while cholesterol crystals were absent in the ursodeoxycholate-treated gallstone patients and in the controls. Total protein concentration and cholesterol saturation index were significantly greater in the untreated gallstone patients with crystals than in those without crystals in bile. The treatment with ursodeoxycholate significantly decreased biliary protein concentration and cholesterol saturation index associated with the prolonged nucleation time. Cholesterol nucleation time correlated with biliary total protein concentration and cholesterol saturation index but not with total lipid concentration. It is concluded from the present study that ursodeoxycholate decreases biliary protein thereby partly increasing metastability of gallbladder bile.
以往研究表明,较高的胆汁蛋白与胆汁稳定性降低有关。本研究试图通过测量胆固醇结石患者的成核时间和胆汁蛋白,来检验熊去氧胆酸对胆汁稳定性的诱导作用。对37例胆囊功能正常的患者进行了研究,其中10例为无结石的对照患者,27例为胆固醇结石患者。27例胆固醇结石患者中有10例在手术前接受了熊去氧胆酸治疗(600毫克/天)。17例未治疗的结石患者中有12例胆囊胆汁中存在胆固醇晶体,而在接受熊去氧胆酸治疗的结石患者和对照患者中则不存在胆固醇晶体。胆汁中有晶体的未治疗结石患者的总蛋白浓度和胆固醇饱和指数显著高于胆汁中无晶体的患者。熊去氧胆酸治疗显著降低了胆汁蛋白浓度和胆固醇饱和指数,同时延长了成核时间。胆固醇成核时间与胆汁总蛋白浓度和胆固醇饱和指数相关,但与总脂质浓度无关。本研究得出结论,熊去氧胆酸可降低胆汁蛋白,从而部分提高胆囊胆汁的稳定性。