Jacyna M R, Ross P E, Hopwood D, Bouchier I A
Department of Medicine, Ninewells Hospital and Medical School, Dundee, Scotland, UK.
Postgrad Med J. 1988 Dec;64(758):931-4. doi: 10.1136/pgmj.64.758.931.
Oral cholecystography is a well established method for studying the human gallbladder and radiological non-visualization of the gallbladder has been shown to correlate highly with the presence of disease. The exact mechanism by which diseased gallbladders fail to visualize is unclear, but may be due to a failure of the gallbladder to concentrate the luminal contents. Concentration of gallbladder contents is achieved by the reabsorption of water, the driving force for which is active sodium (Na+) absorption. Therefore Na+ transport was studied by measuring the flux of Na22 across isolated human gallbladder mucosa (obtained at cholecystectomy) and compared with the results of oral cholecystography and histological grading. In 27 gallbladders studied, 59% absorbed Na+, whilst the remainder secreted Na+. Comparison with histological grading showed that as gallbladders became more diseased they absorbed less Na+ and were more likely to secrete Na+. In addition, gallbladders that absorbed Na+ were significantly more likely to visualize on cholecystography than those that secreted Na+. These results indicate that some diseased human gallbladders secrete, rather than absorb, Na+ and suggest that the mechanism for radiological non-visualization is failure of fluid absorption and the development of active fluid secretion.
口服胆囊造影术是研究人体胆囊的一种成熟方法，胆囊在放射影像上不显影已被证明与疾病的存在高度相关。患病胆囊无法显影的确切机制尚不清楚，但可能是由于胆囊无法浓缩腔内内容物。胆囊内容物的浓缩是通过水的重吸收实现的，其驱动力是活性钠（Na+）的吸收。因此，通过测量Na22穿过离体人胆囊黏膜（在胆囊切除术中获得）的通量来研究Na+转运，并与口服胆囊造影术和组织学分级结果进行比较。在研究的27个胆囊中，59%吸收Na+，其余则分泌Na+。与组织学分级比较表明，随着胆囊病变加重，它们吸收的Na+减少，更有可能分泌Na+。此外，吸收Na+的胆囊在胆囊造影上显影的可能性明显高于分泌Na+的胆囊。这些结果表明，一些患病的人胆囊分泌而非吸收Na+，并提示放射影像不显影的机制是液体吸收失败和活性液体分泌的发展。
