黏蛋白、免疫球蛋白及电解质在胆固醇结石形成中的相关性研究  

Effect of mucin, irnmunoglobuUn and electrolyte on cholesterol lithogenesis

作　　者：刘为民[1] 彭彦辉[1] 王春城[1] 程树杰[2] 韩艳梅[3] 石少慧[3] 

机构地区：[1]河北省人民医院外科,石家庄050000 [2]河北大学医学部外科 [3]河北大学基础部

出　　处：《中国医师进修杂志（外科版）》2007年第2期7-10,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 通过对胆汁中分泌型黏蛋白、免疫球蛋白和游离电解质浓度的分析，探讨黏蛋白、免疫球蛋白、游离钠离子和游离钙离子在胆囊胆固醇结石形成中的作用机制。方法 分别测定27例胆囊胆固醇结石患者（胆囊结石组）和18例胆囊胆固醇息肉患者（对照组）胆汁中黏蛋白、免疫球蛋白（IgA、IgM、IgG）和游离钠离子与游离钙离子浓度。结果 胆囊结石组黏蛋白浓度、IgG浓度较对照组明显增高，P〈0．05；胆囊结石组游离钠离子浓度明显低于对照组，P〈0．05。胆囊结石组游离钙离子浓度明显高于对照组，P〈0．05；黏蛋白浓度与游离钙离子浓度、IgG浓度呈正相关，游离钠离子浓度与黏蛋白浓度呈明显负相关。结论胆固醇结石形成与细菌感染产生的感染相关蛋白密切相关，其中分泌型黏蛋白、免疫球蛋白IgG等感染相关蛋白在胆石形成中通过与某些离子或其他分子结合形成不溶性物质而起重要作用。低张钠离子能加强钙离子与黏蛋白及免疫球蛋白的结合形成难溶性物质，促使结石形成。Objective To evaluate the effect of mucin, immunoglobulin and electrolyte on cho- lesterol lithogenesis. Methods The levels of bile mucin, immunoglobulin and electrolyte as free Ca^2＋ and free Na^＋ were measured in 27 cases of gallbladder cholesterol calculus （trial group） and 18 cases of gallbladder polypi （control group）. Mucin in gallbladder bile was measured by Fullion- hydroxybenzene method, immunoglobulin was measured by immunoturbidimetry, free Na ^＋ and free Ca^2＋ were measured by biochemical method. Results The level of mucin in trial group increased significantly than that in control group （ P 〈 0.05 ）. IgG in trial group was significantly higher than that in control group （ P 〈 0. 05 ）. The concentration of free Ca^2＋ in trial group was higher than that in control group （ P 〈 0.05 ）. The concentration of free Na ^＋ in trial group was significantly lower than that in control group （ P 〈 0.05 ）. The concentration of mucin correlated positively with free Ca^2＋ and IgG in trial group. The concentration of Ca^2＋ correlated positively with IgG in trial group. The concentration of free Na^＋ correlated negatively with mucin and free Ca^2＋ in trial group. Conclusions The formation of gallbladder cholesterol calculus is concerned with some soluble substances such as mucin, immunoglobulin, and some electrolyte ions that exist in lithogenic gallbladder bile, which form insoluble substances by integrating with each other. Hypotonic Na^＋ can enhance the combination between free mucin, Ca^2＋ and immunoglobulin, which urge the calculus＇ formation.

关 键 词：黏蛋白 游离钙离子 游离钠离子 胆固醇结石 免疫球蛋白 胆囊胆汁 结石形成 细菌 

分 类 号：R364.25[医药卫生—病理学]