Sharma B C, Agarwal D K, Baijal S S, Saraswat V A
Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
J Clin Gastroenterol. 1997 Sep;25(2):433-6. doi: 10.1097/00004836-199709000-00007.
Pravastatin dissolves gallstones in patients with hypercholesterolemia by reducing the cholesterol saturation index (CSI) of bile. There are few reports on effect of pravastatin on bile lipids, CSI and nucleation time (NT) in patients with gallstones and normal plasma lipid levels, or on the effect of pravastatin on gallbladder motility. Therefore we studied the effect of pravastatin on bile lipids, CSI, NT, and gallbladder motility in persons with normal cholesterol levels. We included 10 patients (ages 32 +/- 8 years; 6 men) with symptomatic gallstones and normal plasma lipid profiles. Estimation of bile lipids, CSI, and NT in duodenal bile and gallbladder motility were done using standard methods. Subsequently each patient was given 40 mg pravastatin daily for 1 month. At completion of pravastatin therapy, bile lipids and gallbladder motility studies were repeated. After pravastatin therapy, we found no significant reduction in bile cholesterol (11.2 +/- 3.2 vs. 10.4 +/- 2.8 mmol/l), bile acids (114.6 +/- 7.4 vs. 133 +/- 16 mmol/l), phospholipids (23 +/- 3.5 vs. 24 +/- 6.2 mmol/l), CSI (1.28 +/- 0.4 vs. 1.22 +/- 0.3), and nucleation time (7 +/- 3 vs. 7 +/- 3 days). In addition, there was no significant change in gallbladder fasting volume (26 +/- 3 vs. 26.6 +/- 3 ml), residual volume (14.6 +/- 1.1 vs. 15.08 +/- 1.4 ml), ejection fraction (44% vs. 43%), and rate constant of gallbladder emptying (0.018/min vs. 0.022/min). One-month therapy with pravastatin does not alter bile lipids, CSI, NT, and gallbladder contractility in persons with normal levels of cholesterol.
普伐他汀通过降低胆汁的胆固醇饱和指数(CSI)来溶解高胆固醇血症患者的胆结石。关于普伐他汀对血脂正常的胆结石患者胆汁脂质、CSI和成核时间(NT)的影响,以及对胆囊运动的影响,报道较少。因此,我们研究了普伐他汀对胆固醇水平正常者胆汁脂质、CSI、NT和胆囊运动的影响。我们纳入了10例有症状胆结石且血脂谱正常的患者(年龄32±8岁;6例男性)。采用标准方法对十二指肠胆汁中的胆汁脂质、CSI和NT以及胆囊运动进行评估。随后,每位患者每天服用40mg普伐他汀,持续1个月。普伐他汀治疗结束后,重复进行胆汁脂质和胆囊运动研究。普伐他汀治疗后,我们发现胆汁胆固醇(11.2±3.2对10.4±2.8mmol/L)、胆汁酸(114.6±7.4对133±16mmol/L)、磷脂(23±3.5对24±6.2mmol/L)、CSI(1.28±0.4对1.22±0.3)和成核时间(7±3对7±3天)均无显著降低。此外,胆囊空腹容积(26±3对26.6±3ml)、残余容积(14.6±1.1对15.08±1.4ml)、射血分数(44%对43%)和胆囊排空速率常数(0.018/min对0.022/min)也无显著变化。对于胆固醇水平正常的人,为期一个月的普伐他汀治疗不会改变胆汁脂质、CSI、NT和胆囊收缩力。