Lanzini A, Northfield T C
Department of Medicine II, St George's Hospital Medical School, London.
Gut. 1990 Feb;31(2):226-30. doi: 10.1136/gut.31.2.226.
We have carried out overnight measurements of hepatic secretion rate and duodenal output of biliary lipids using a duodenal perfusion technique. We correlated these measurements with the fasting state mass of biliary lipids within the gall bladder on the following morning using a combined nasoduodenal intubation and isotope scanning technique. We studied six gall stone subjects before and during treatment with ursodeoxycholic acid 675 mg/day. Lipid mass within the gall bladder correlated with the corresponding overnight hepatic secretion rate for all three biliary lipids. During ursodeoxycholic acid treatment, there was an increase in gall bladder bile acid mass without significant change in cholesterol or phospholipid mass. We conclude that the mass of individual biliary lipids within the fasting gall bladder is influenced by overnight hepatic biliary lipid secretion rate; and that the effect of ursodeoxycholic acid (675 mg/day) on cholesterol saturation index of fasting gall bladder bile is mediated via an increase in bile acid mass rather than through a decrease in cholesterol mass within the gall bladder.
我们采用十二指肠灌注技术对肝分泌率和胆汁脂质的十二指肠输出量进行了夜间测量。我们使用联合鼻十二指肠插管和同位素扫描技术，将这些测量结果与次日早晨胆囊内胆汁脂质的空腹状态质量进行了关联。我们研究了6名胆结石患者在接受每日675毫克熊去氧胆酸治疗前及治疗期间的情况。胆囊内的脂质质量与所有三种胆汁脂质相应的夜间肝分泌率相关。在熊去氧胆酸治疗期间，胆囊胆汁酸质量增加，而胆固醇或磷脂质量无显著变化。我们得出结论，空腹胆囊内单个胆汁脂质的质量受夜间肝胆汁脂质分泌率的影响；并且熊去氧胆酸（每日675毫克）对空腹胆囊胆汁胆固醇饱和指数的影响是通过增加胆汁酸质量介导的，而不是通过降低胆囊内胆固醇质量来实现的。
