LaRusso N F, Thistle J L
Gastroenterology. 1983 Feb;84(2):265-71.
We measured intestinal absorption of cholesterol by a plasma isotope ratio method and determined biliary bile acid and lipid composition of fasting gallbladder bile in 5 gallstone patients before therapy and during two randomized treatment periods with chenodeoxycholic or ursodeoxycholic acid (13 mg/kg . day). During chenodeoxycholic acid ingestion, biliary bile acids were composed predominantly (84%) of conjugates of chenodeoxycholic acid. During ursodeoxycholic acid administration, conjugates of ursodeoxycholic acid constituted half the bile acid pool (49%). Fasting gallbladder bile was supersaturated in cholesterol before treatment, but became unsaturated during administration of both chenodeoxycholic and ursodeoxycholic acids. In spite of these marked changes in biliary bile acid and lipid composition, cholesterol absorption was not significantly different before (45.4 +/- 4.3%, mean +/- SEM) or after chenodeoxycholic (42.7 +/- 5.1%) or ursodeoxycholic (46.8 +/- 3.7%) acid ingestion. We conclude that chenodeoxycholic and ursodeoxycholic acids unsaturate bile in cholesterol and dissolve gallstones by a mechanism other than the suppression of intestinal absorption of cholesterol.
我们采用血浆同位素比率法测定了胆固醇的肠道吸收情况，并在5例胆结石患者治疗前以及用鹅去氧胆酸或熊去氧胆酸（13毫克/千克·天）进行两个随机治疗阶段期间，测定了空腹胆囊胆汁中的胆汁酸和脂质成分。在摄入鹅去氧胆酸期间，胆汁酸主要由鹅去氧胆酸的结合物组成（84%）。在给予熊去氧胆酸期间，熊去氧胆酸的结合物占胆汁酸池的一半（49%）。治疗前空腹胆囊胆汁中的胆固醇呈过饱和状态，但在给予鹅去氧胆酸和熊去氧胆酸期间均变为不饱和状态。尽管胆汁酸和脂质成分发生了这些显著变化，但在摄入鹅去氧胆酸（45.4±4.3%，平均值±标准误）、鹅去氧胆酸（42.7±5.1%）或熊去氧胆酸（46.8±3.7%）前后，胆固醇吸收并无显著差异。我们得出结论，鹅去氧胆酸和熊去氧胆酸可使胆汁中的胆固醇不饱和，并通过抑制胆固醇肠道吸收以外的机制溶解胆结石。
