Forgacs I C, Maisey M N, Murphy G M, Dowling R H
Gastroenterology. 1984 Aug;87(2):299-307.
Altered gallbladder motility could predispose to, or result from, gallstone formation and could also explain the alleged relief of biliary colic seen during bile acid therapy. Therefore, in 14 controls, 25 patients with radiolucent gallstones, and 14 patients with radiopaque gallstones, we used two techniques to measure gallbladder contraction--radionuclide imaging and real-time ultrasound--in response to one of two stimuli--a Lundh meal or intravenous cholecystokinin-octapeptide. Using the radionuclide technique, postprandial gallbladder emptying (t1/2) was prolonged (p less than 0.01) both in patients with radiopaque (26.7 +/- 3.1 min, mean +/- SEM) and radiolucent (21.7 +/- 3.1) gallstones when compared with controls (10.2 +/- 1.5). In patients with radiolucent stones, the t1/2 of gallbladder emptying became further prolonged (p less than 0.05) after 1 mo of therapy with 8-10 mg/kg body wt X day of ursodeoxycholic acid, to 32.1 +/- 4.4 min. A similar pattern of results was seen after cholecystokinin-octapeptide and also with real-time ultrasound. Thus, after both stimuli and using two independent techniques, gallbladder contraction was reduced in patients with gallstones. The slower and less complete gallbladder emptying with ursotherapy might explain the reduction in biliary colic noted during treatment.
胆囊运动功能改变可能是胆结石形成的诱因或结果，也可以解释胆汁酸治疗期间胆绞痛症状减轻的原因。因此，我们选取了14名对照者、25名X线透光性胆结石患者和14名X线不透光性胆结石患者，采用两种技术——放射性核素成像和实时超声——来测量胆囊对两种刺激之一（一种标准试餐或静脉注射胆囊收缩素八肽）的收缩反应。采用放射性核素技术时，与对照者（10.2±1.5分钟）相比，X线不透光性胆结石患者（26.7±3.1分钟，均值±标准误）和X线透光性胆结石患者（21.7±3.1分钟）餐后胆囊排空时间（t1/2）均延长（p<0.01）。对于X线透光性胆结石患者，在接受每天8-10mg/kg体重熊去氧胆酸治疗1个月后，胆囊排空t1/2进一步延长（p<0.05），至32.1±4.4分钟。胆囊收缩素八肽刺激后以及实时超声检查时也出现了类似的结果模式。因此，在两种刺激下并采用两种独立技术检测时，胆结石患者的胆囊收缩均减弱。熊去氧胆酸疗法使胆囊排空更缓慢、更不完全，这可能解释了治疗期间胆绞痛症状减轻的原因。
