Ho K J, Hsu S C, Chen J S, Ho L H
Eur J Clin Invest. 1986 Oct;16(5):361-7. doi: 10.1111/j.1365-2362.1986.tb01010.x.
Total and conjugated bilirubin contents of gall-bladder and hepatic biles before and after 24-h incubation at 37 degrees C and beta-glucuronidase activity of hepatic biles were determined in forty-eight patients divided equally into four groups: no stones or control (C), cholesterol stones (CS), black pigment stones (black PS), and brown pigment stones (brown PS). The percent conjugation of bilirubin is lower in gall-bladder biles and hepatic biles after incubation, particularly in black PS and brown PS, when compared with hepatic biles before incubation. Mean endogenous beta-glucuronidase activities at pH 5.2 were 12.0, 15.5, 44.5 and 147.7 nmol min-1 ml-1 for C, CS, black PS, and Brown PS, respectively, which correlated well with the degree of deconjugation of bilirubin in gall-bladder and hepatic biles and with the rate of deconjugation of hepatic bile incubated at 37 degrees C. Only four biles in brown PS exhibited bacterial enzyme activity. We concluded that though bacterial beta-glucuronidase might be responsible for deconjugation of bilirubin in some patients in brown PS, endogenous biliary beta-glucuronidase could play a key role in the pathogenesis of pigment cholelithiasis.
将48例患者平均分为四组:无结石或对照组(C)、胆固醇结石组(CS)、黑色色素结石组(黑色PS)和棕色色素结石组(棕色PS),测定了37℃孵育24小时前后胆囊胆汁和肝胆汁中总胆红素和结合胆红素含量以及肝胆汁中β-葡萄糖醛酸酶活性。与孵育前的肝胆汁相比,孵育后胆囊胆汁和肝胆汁中胆红素的结合百分比降低,尤其是在黑色PS和棕色PS中。在pH 5.2时,C组、CS组、黑色PS组和棕色PS组的平均内源性β-葡萄糖醛酸酶活性分别为12.0、15.5、44.5和147.7 nmol min-1 ml-1,这与胆囊胆汁和肝胆汁中胆红素的去结合程度以及37℃孵育的肝胆汁的去结合速率密切相关。棕色PS组中只有四份胆汁表现出细菌酶活性。我们得出结论,虽然细菌β-葡萄糖醛酸酶可能在某些棕色PS患者中导致胆红素去结合,但内源性胆汁β-葡萄糖醛酸酶可能在色素性胆石症的发病机制中起关键作用。