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不同剂量鹅去氧胆酸对胆结石患者胆汁脂质及胆汁酸成分的影响:一项剂量反应研究

Effect of varying doses of chenodeoxycholic acid on bile lipid and biliary bile acid composition in gallstone patients: a dose-response study.

作者信息

Thistle J L, Hofmann A F, Yu P Y, Ott B

出版信息

Am J Dig Dis. 1977 Jan;22(1):1-6. doi: 10.1007/BF01077389.

DOI:10.1007/BF01077389
PMID:835542
Abstract

In a dose-response study, a formulation of chenodeoxycholic acid (chenic acid) with complete bioavailability was fed at doses of 0, 250, 500, 750 mg for randomized 6-week periods to 13 patients with radiolucent gallstones. The proportion of chenic acid in biliary bile acids increased in direct relation to dose. Lithocholic acid also increased, but ursodeoxycholic acid showed no significant change. Bile saturation decreased with increasing dose, but response was variable and achieved significance only at 750 mg/day. Cholesterol saturation was negatively correlated with the proportion of chenic acid in biliary bile acids: When biliary bile acids contained greater than 70% chenic acid (and ursodeoxycholic acid), bile became unsaturated, on the average. The data suggest that a dose of at least 10-15 mg/kg may be necessary to obtain desaturation in many gallstone patients.

摘要

在一项剂量反应研究中,将具有完全生物利用度的鹅去氧胆酸(鹅胆酸)制剂以0、250、500、750毫克的剂量,随机给予13名患有透X线胆结石的患者,为期6周。胆汁中鹅胆酸的比例与剂量呈直接关系增加。石胆酸也增加,但熊去氧胆酸无显著变化。胆汁饱和度随剂量增加而降低,但反应存在差异,仅在750毫克/天时达到显著水平。胆固醇饱和度与胆汁中鹅胆酸的比例呈负相关:当胆汁中鹅胆酸(和熊去氧胆酸)含量大于70%时,胆汁平均变为不饱和。数据表明,在许多胆结石患者中,可能需要至少10 - 15毫克/千克的剂量才能实现去饱和。

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Effect of varying doses of chenodeoxycholic acid on bile lipid and biliary bile acid composition in gallstone patients: a dose-response study.不同剂量鹅去氧胆酸对胆结石患者胆汁脂质及胆汁酸成分的影响:一项剂量反应研究
Am J Dig Dis. 1977 Jan;22(1):1-6. doi: 10.1007/BF01077389.
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JAMA. 1978 Mar 20;239(12):1138-44. doi: 10.1001/jama.239.12.1138.
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Gastroenterology. 1975 Dec;69(6):1301-14.
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Effect of oral chenodeoxycholic acid on bile acid kinetics and biliary lipid composition in women with cholelithiasis.口服鹅去氧胆酸对胆石症女性胆汁酸动力学和胆汁脂质成分的影响。
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Mass spectrometry identification of biliary bile acids in bile from patients with gallstones before and during treatment with chenodeoxycholic acid. An ancillary study of the National Cooperative Gallstone Study.质谱法鉴定胆石症患者在鹅去氧胆酸治疗前后胆汁中的胆汁酸。美国国立胆石症合作研究的一项辅助研究。
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Metabolism of ursodeoxycholic acid in man.熊去氧胆酸在人体内的代谢
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本文引用的文献

1
A simplified method for the estimation of total cholesterol in serum and demonstration of its specificity.一种估算血清总胆固醇的简化方法及其特异性验证。
J Biol Chem. 1952 Mar;195(1):357-66.
2
Increased formation of ursodeoxycholic acid in patients treated with chenodeoxycholic acid.用鹅去氧胆酸治疗的患者中熊去氧胆酸的生成增加。
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3
Induced alterations in composition of bile of persons having cholelithiasis.胆结石患者胆汁成分的诱导性改变。
“陈诺”与“优思弗”在胆结石医学治疗中的回顾性比较
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Differing effects of ursodeoxycholic or chenodeoxycholic acid on biliary cholesterol saturation and bile acid metabolism in man. A dose-response study.熊去氧胆酸或鹅去氧胆酸对人体胆汁胆固醇饱和度及胆汁酸代谢的不同影响。一项剂量反应研究。
Dig Dis Sci. 1982 Feb;27(2):161-8. doi: 10.1007/BF01311711.
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Chenodeoxycholic acid: a review of its pharmacological properties and therapeutic use.鹅去氧胆酸:其药理特性与治疗用途综述
Drugs. 1981 Feb;21(2):90-119. doi: 10.2165/00003495-198121020-00002.
6
The effects of chenodiol on biliary lipids and their association with gallstone dissolution in the National Cooperative Gallstone Study (NCGS).在全国合作胆结石研究(NCGS)中,鹅去氧胆酸对胆汁脂质的影响及其与胆结石溶解的关系。
J Clin Invest. 1984 Apr;73(4):1156-66. doi: 10.1172/JCI111301.
7
Deoxycholic acid and the pathogenesis of gall stones.脱氧胆酸与胆结石的发病机制
Gut. 1988 Apr;29(4):522-33. doi: 10.1136/gut.29.4.522.
Gastroenterology. 1971 Oct;61(4):488-96.
4
The solubility of cholesterol in aqueous solutions of bile salts and lecithin.胆固醇在胆盐和卵磷脂水溶液中的溶解度。
Z Ernahrungswiss. 1971 Apr;10(3):223-33. doi: 10.1007/BF02020933.
5
Role of bile acid malabsorption in pathogenesis of diarrhea and steatorrhea in patients with ileal resection. I. Response to cholestyramine or replacement of dietary long chain triglyceride by medium chain triglyceride.胆汁酸吸收不良在回肠切除患者腹泻和脂肪泻发病机制中的作用。I. 对消胆胺的反应或用中链甘油三酯替代膳食长链甘油三酯。
Gastroenterology. 1972 May;62(5):918-34.
6
[Morphology of gallstones (author's transl)].[胆结石的形态学(作者译)]
Leber Magen Darm. 1974 Apr;4(2):43-57.
7
Letter: A simple calculation of the lithogenic index of bile: expressing biliary lipid composition on rectangular coordinates.信函:胆汁成石指数的简单计算:在直角坐标上表示胆汁脂质成分
Gastroenterology. 1973 Oct;65(4):698-700.
8
Cholesterol solubility in bile. Evidence that supersaturated bile is frequent in healthy man.胆固醇在胆汁中的溶解度。健康人胆汁经常呈过饱和状态的证据。
J Clin Invest. 1973 Jun;52(6):1467-79. doi: 10.1172/JCI107321.
9
Effect of oral chenodeoxycholic acid on bile acid kinetics and biliary lipid composition in women with cholelithiasis.口服鹅去氧胆酸对胆石症女性胆汁酸动力学和胆汁脂质成分的影响。
J Clin Invest. 1973 Nov;52(11):2809-21. doi: 10.1172/JCI107477.
10
Efficacy and specificity of chenodeoxycholic acid therapy for dissolving gallstones.鹅去氧胆酸治疗胆囊结石的疗效与特异性
N Engl J Med. 1973 Sep 27;289(13):655-9. doi: 10.1056/NEJM197309272891303.