Juvonen T, Kervinen K, Kairaluoma M I, Kesäniemi Y A
Department of Surgery, University of Oulu.
Hepatogastroenterology. 1995 Jul-Aug;42(4):377-82.
BACKGROUND/AIM: This study was designed to elucidate the effect of cholecystectomy, a common surgical procedure, on the concentrations of plasma lipids and lipoproteins.
19 consecutive patient with symptomatic gallstone disease and emptying gallbladder, and 16 control patients (Nissen-Rosetti fundoplication) were studied. Cholesterol, triglyceride, and protein concentrations of various lipoproteins were analysed.
Plasma total and LDL cholesterol levels were significantly reduced in cholecystectomy patients (p = 0.0048 and p=0.0239) at day 3 after the operation, the values returning to the preoperative level thereafter. In the control patients similar trends were observed for total and LDL cholesterol levels but these changes did not reach statistical significance. In cholecystectomy patients a significant increase was noticed in the very-low-density lipoprotein and intermediate density lipoprotein apoprotein B concentration three years after surgery (p= 0.0019 and p=0.0001).
These minor changes in plasma lipoproteins following cholecystectomy are unlikely to have any importance in the development coronary heart disease. They indicate, however, altered enterohepatic metabolism of cholesterol after the removal of the gallbladder.
背景/目的:本研究旨在阐明胆囊切除术(一种常见的外科手术)对血浆脂质和脂蛋白浓度的影响。
对19例有症状的胆囊结石病且胆囊已排空的连续患者以及16例对照患者(尼森-罗塞蒂胃底折叠术)进行了研究。分析了各种脂蛋白的胆固醇、甘油三酯和蛋白质浓度。
胆囊切除术后第3天,患者血浆总胆固醇和低密度脂蛋白胆固醇水平显著降低(p = 0.0048和p = 0.0239),此后这些值恢复到术前水平。在对照患者中,总胆固醇和低密度脂蛋白胆固醇水平观察到类似趋势,但这些变化未达到统计学意义。胆囊切除术后三年,患者极低密度脂蛋白和中间密度脂蛋白载脂蛋白B浓度显著增加(p = 0.0019和p = 0.0001)。
胆囊切除术后血浆脂蛋白的这些微小变化在冠心病的发生中不太可能具有任何重要意义。然而,它们表明胆囊切除后胆固醇的肠肝代谢发生了改变。