van Erpecum K J, van Berge Henegouwen G P, Stolk M F
Department of Gastroenterology, University Hospital Utrecht, The Netherlands.
Clin Chim Acta. 1991 Jul 15;199(3):295-303. doi: 10.1016/0009-8981(91)90123-t.
It has been previously reported that patients with cholesterol gallstones have increased biliary deoxycholate and arachidonate content as compared with normal subjects without gallstones. Increased biliary deoxycholate and arachidonate content might be a primary factor in the pathogenesis of cholesterol gallstones or merely an epiphenomenon due to the presence of gallstones. We therefore compared biliary bile acid composition in 46 patients with cholesterol gallstones and 22 patients with pigment stones. In addition, biliary phospholipid fatty acid composition was determined in 44 of these patients (30 cholesterol and 14 pigment stone patients). No significant differences were detected. In particular, the percentage deoxycholic acid (mean +/- SD: 20.3 +/- 8.8% and 21.5 +/- 10.9% respectively) and the percentage arachidonic acid (4.4 +/- 2.0% and 4.5 +/- 2.2%, respectively) were very similar. A significant correlation between age and biliary cholesterol saturation index was found only for the group of patients with pigment stones (R = 0.52, p less than 0.02). In conclusion, the present study does not support a primary role for increased biliary deoxycholic acid or arachidonic acid in the pathogenesis of cholesterol gallstones.
此前已有报道称，与无胆结石的正常受试者相比，胆固醇结石患者胆汁中的脱氧胆酸盐和花生四烯酸盐含量有所增加。胆汁中脱氧胆酸盐和花生四烯酸盐含量的增加可能是胆固醇结石发病机制中的一个主要因素，或者仅仅是由于胆结石的存在而产生的一种附带现象。因此，我们比较了46例胆固醇结石患者和22例色素结石患者的胆汁酸组成。此外，还对其中44例患者（30例胆固醇结石患者和14例色素结石患者）的胆汁磷脂脂肪酸组成进行了测定。未检测到显著差异。特别是，脱氧胆酸的百分比（分别为平均值±标准差：20.3±8.8%和21.5±10.9%）和花生四烯酸的百分比（分别为4.4±2.0%和4.5±2.2%）非常相似。仅在色素结石患者组中发现年龄与胆汁胆固醇饱和指数之间存在显著相关性（R = 0.52，p＜0.02）。总之，本研究不支持胆汁中脱氧胆酸或花生四烯酸增加在胆固醇结石发病机制中起主要作用的观点。
