Rådberg G, Friman S, Samsioe G, Svanvik J
Dept. of Surgery I, Sahlgren's Hospital, Gothenburg, Sweden.
Scand J Gastroenterol. 1987 Sep;22(7):827-32. doi: 10.3109/00365528708991922.
Contraceptive steroids that increase the risk of gallstones reduce the bile acid pool size and increase the cholesterol saturation in bile. To analyze mechanisms behind these effects, bile acid enterohepatic circulation was studied with direct methods in cats treated with peroral contraceptive steroids for 3 months, cats oophorectomized 1-2 months before study, and female control animals. Both administration of contraceptive steroids and oophorectomy reduced the bile acid pool size and bile acid synthesis rate. Contraceptive steroids increased water secretion by the liver at low bile acid secretion rates, reduced bile acid accumulation in the gallbladder, and increased the recycling rate of the bile acid pool. Oophorectomy did not significantly change the relation between bile acid and water secretion by the liver. The reduced bile acid pool size in animals receiving contraceptive steroids can be explained by an increased recycling rate induced by an enhanced water secretion by the liver. The possibility of a direct effect on the hepatic synthesis of bile acids by both administration of contraceptive steroids and oophorectomy cannot be excluded.
增加胆结石风险的避孕类固醇会减小胆汁酸池大小并增加胆汁中的胆固醇饱和度。为分析这些作用背后的机制，采用直接方法对口服避孕类固醇3个月的猫、在研究前1 - 2个月进行卵巢切除的猫以及雌性对照动物的胆汁酸肝肠循环进行了研究。给予避孕类固醇和进行卵巢切除均减小了胆汁酸池大小和胆汁酸合成速率。避孕类固醇在低胆汁酸分泌速率时增加肝脏的水分泌，减少胆囊中胆汁酸的积聚，并增加胆汁酸池的循环速率。卵巢切除并未显著改变肝脏胆汁酸与水分泌之间的关系。接受避孕类固醇的动物胆汁酸池大小减小可通过肝脏增强水分泌诱导的循环速率增加来解释。不能排除给予避孕类固醇和进行卵巢切除对肝脏胆汁酸合成产生直接影响的可能性。
