Wu Shuo-Dong, Uchiyama Kazuhisa, Fan Ying
Department of General Surgery, Shengjing Hospital, China Medical University, Shenyang 110004, China.
Hepatobiliary Pancreat Dis Int. 2007 Aug;6(4):399-401.
Cholelithiasis is a common entity in China, but its etiology and pathogenesis have not been fully elucidated. Pigment stones of the intrahepatic and extrahepatic bile duct still form a high proportion in China, while they are rare in Europeans. To date, reports on fatty acids in stones remain few. We analyzed the quantity of fatty acids in different stones from Chinese and Japanese cases and discussed the role and mechanism of fatty acids in the formation of pigment stones.
Clinical data from 18 Chinese and 37 Japanese patients with different types of stones were analyzed using the procedure for extracting fatty acids from gallstones and high performance liquid chromatography.
The total fatty acid and free fatty acid contents of pigment stones were markedly higher than those in black or cholesterol stones. The ratio of free saturated to free unsaturated fatty acids was highest in intrahepatic and less in extrahepatic pigment stones, which were significantly different from the other two kinds of stones.
This indicates that phospholipase participates in the course of pigment stone formation. The action of phospholipase A1 is more important than phospholipase A2.
胆石症在中国是一种常见病症，但其病因和发病机制尚未完全阐明。在我国，肝内和肝外胆管色素结石仍占较高比例，而在欧洲人当中则较为罕见。迄今为止，关于结石中脂肪酸的报道仍然很少。我们分析了中国和日本病例中不同结石的脂肪酸含量，并探讨了脂肪酸在色素结石形成中的作用和机制。
采用从胆结石中提取脂肪酸的方法和高效液相色谱法，分析了18例中国患者和37例日本患者不同类型结石的临床资料。
色素结石的总脂肪酸和游离脂肪酸含量明显高于黑色结石或胆固醇结石。肝内色素结石中游离饱和脂肪酸与游离不饱和脂肪酸的比例最高，肝外色素结石中的比例较低，这与其他两种结石有显著差异。
这表明磷脂酶参与了色素结石的形成过程。磷脂酶A1的作用比磷脂酶A2更重要。
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