Sahlin S, Ahlberg J, Angelin B, Ewerth S, Nilsell K, Reihnér E, Einarsson K
Department of Surgery, Karolinska Institute, Danderyd Hospital, Stockholm, Sweden.
Eur J Clin Invest. 1988 Aug;18(4):386-90. doi: 10.1111/j.1365-2362.1988.tb01028.x.
The occurrence of cholesterol monohydrate crystals was examined and related to the degree of cholesterol saturation in gallbladder bile and hepatic bile of gallstone (GS) patients (n = 34), gallstone-free (GSF) subjects (n = 33) and GS patients treated with chenodeoxycholic acid (CDCA (n = 7) or ursodeoxycholic acid (UDCA) (n = 11) for 3 weeks prior to cholecystectomy. Twenty-five untreated GS patients (74%) and four UDCA-treated patients (40%) displayed cholesterol crystals in the gallbladder bile. Only two GSF subjects (6%) and none of the CDCA-treated patients had crystals. Half of the patients with crystals in the gallbladder bile had crystals also in the hepatic bile. Cholesterol saturation of the gallbladder bile was higher in GS (142 +/- 15%, mean +/- SEM) than in GSF patients (74 +/- 5%). Saturation was also higher in GS patients with crystals (157 +/- 20%) than in those without crystals (99 +/- 12%). Gallbladder bile was unsaturated in all CDCA- and UDCA-treated patients. The results underline the importance of the degree of cholesterol saturation for the formation of cholesterol crystals. The data also give further support to the concept that the mechanism for inducing gallstone dissolution is different for CDCA and UDCA.
研究了胆固醇单水合物晶体的出现情况，并将其与胆结石（GS）患者（n = 34）、无胆结石（GSF）受试者（n = 33）以及在胆囊切除术前3周接受鹅去氧胆酸（CDCA，n = 7）或熊去氧胆酸（UDCA，n = 11）治疗的GS患者的胆囊胆汁和肝胆汁中的胆固醇饱和度相关联。25例未治疗的GS患者（74%）和4例接受UDCA治疗的患者（40%）在胆囊胆汁中出现了胆固醇晶体。只有2例GSF受试者（6%）出现晶体，而接受CDCA治疗的患者均未出现晶体。胆囊胆汁中有晶体的患者中，一半在肝胆汁中也有晶体。GS患者胆囊胆汁的胆固醇饱和度（142±15%，平均值±标准误）高于GSF患者（74±5%）。有晶体的GS患者的饱和度（157±20%）也高于无晶体的患者（99±12%）。所有接受CDCA和UDCA治疗的患者的胆囊胆汁均不饱和。结果强调了胆固醇饱和度对于胆固醇晶体形成的重要性。这些数据也进一步支持了CDCA和UDCA诱导胆结石溶解的机制不同这一概念。
