Scriven M W, Horrobin D F, Puntis M C
Hepato-Pancreatico-Biliary Surgery Unit, University of Wales College of Medicine, Cardiff.
Gut. 1994 Jul;35(7):987-90. doi: 10.1136/gut.35.7.987.
The poor outcome in patients with extrahepatic cholestatic jaundice seems in some way related to reticuloendothelial dysfunction. Similar dysfunction can be caused by abnormal tissue phospholipid fatty acid patterns. Little is, however, known about such patterns in extrahepatic cholestatic jaundice. The phospholipid fatty acid patterns in 42 controls were compared with 42 patients with extrahepatic cholestatic jaundice. Many abnormalities were found. The general pattern was of a fall in polyunsaturated fatty acids and a rise in monounsaturated fatty acids, with a consequent fall in the double bond index (mean number of double bonds per fatty acid) showing an overall rise in saturation. All three major substrates for eicosanoid production were reduced in the jaundiced group. The changes seemed to be associated with jaundice itself, rather than the cause of the jaundice. The central roles of fatty acids in the determination of membrane function and in the provision of substrates of eicosanoid production, mean that these changes may explain some of the reticuloendothelial dysfunction found in extrahepatic cholestatic jaundice.
肝外胆汁淤积性黄疸患者预后较差，这似乎在某种程度上与网状内皮系统功能障碍有关。类似的功能障碍可能由异常的组织磷脂脂肪酸模式引起。然而，对于肝外胆汁淤积性黄疸中的此类模式知之甚少。将42名对照者的磷脂脂肪酸模式与42名肝外胆汁淤积性黄疸患者进行了比较。发现了许多异常情况。总体模式是多不饱和脂肪酸减少，单不饱和脂肪酸增加，结果双键指数（每个脂肪酸的双键平均数）下降，表明饱和度总体上升。黄疸组中类花生酸产生的所有三种主要底物均减少。这些变化似乎与黄疸本身有关，而不是与黄疸的病因有关。脂肪酸在决定膜功能和提供类花生酸产生的底物方面的核心作用，意味着这些变化可能解释了肝外胆汁淤积性黄疸中发现的一些网状内皮系统功能障碍。
