Kajiyama G, Fujiyama M, Takata K, Miyoshi A
Gastroenterol Jpn. 1981 Dec;16(6):553-62. doi: 10.1007/BF02813789.
Serum lipids and lipoproteins of gallstone patients were analyzed and compared with lithogenesity of bile and type of stones by roentgenographic and cross-sectional views. Incidences of hypercholesterolemia and triglyceridemia were higher in patients with radiolucent gallstones than with radiopaque stones. Furthermore, an incidence of hypertriglyceridemia was higher in patients with radiolucent solitary stones than with radiolucent multiple stones. The degrees of hyperlipidemia were moderate. Lipoprotein disc electrophoresis of sera of hyperlipidemic patients revealed type IIa, IIb or IV. More solitary and less multiple stones were seen in the hyperlipoproteinemic patients than normolipoproteinemic. Multiple stones with normolipoproteinemia were more accompanied by unsaturated bile (lithogenic index less than 1.0) than those with hyperlipoproteinemia and solitary stones with hyperlipoproteinemia or without. Solitary stones obtained surgically from normolipoproteinemic patients were pure cholesterol, combination or mixed stones, while multiple stones not including pure cholesterol and combination stones with pure cholesterol in the center. Solitary stones in hyperlipoproteinemic patients proved mostly either pure cholesterol or combination stones with pure cholesterol ins the center, while multiple stones containing all types of stones inclusive of a small number of other miscellaneous stones except cholesterol stones. Collectively more mixed and other miscellaneous stones except cholesterol stones, and less pure cholesterol and combination stones with pure cholesterol in the center were shown in normolipidemic patients, and vice versa in hyperlipoproteinemic patients. These results suggested serum lipids and lipoproteins being closely related to the initial precipitation, aggregation of cholesterol crystals and development of cholesterol gallstones through lipid metabolism of the whole body.
对胆结石患者的血清脂质和脂蛋白进行了分析，并通过X线摄影和横断面视图将其与胆汁的成石性和结石类型进行了比较。透X线胆结石患者的高胆固醇血症和高甘油三酯血症发生率高于不透X线结石患者。此外，透X线孤立性结石患者的高甘油三酯血症发生率高于透X线多发性结石患者。高脂血症程度为中度。高脂血症患者血清的脂蛋白圆盘电泳显示为IIa型、IIb型或IV型。高脂蛋白血症患者中孤立性结石较多，多发性结石较少，而正常脂蛋白血症患者则相反。正常脂蛋白血症患者的多发性结石比高脂蛋白血症患者和高脂蛋白血症或无高脂蛋白血症的孤立性结石更常伴有不饱和胆汁（成石指数小于1.0）。从正常脂蛋白血症患者手术获取的孤立性结石为纯胆固醇结石、混合型或混合性结石，而多发性结石不包括纯胆固醇结石以及中心为纯胆固醇的混合型结石。高脂蛋白血症患者的孤立性结石大多为纯胆固醇结石或中心为纯胆固醇的混合型结石，而多发性结石包含所有类型的结石，包括少数除胆固醇结石外的其他杂石。总体而言，正常脂蛋白血症患者中除胆固醇结石外的混合性和其他杂石较多，中心为纯胆固醇的纯胆固醇结石和混合型结石较少，而高脂蛋白血症患者则相反。这些结果表明，血清脂质和脂蛋白通过全身脂质代谢与胆固醇晶体的初始沉淀、聚集以及胆固醇胆结石的形成密切相关。
