胆固醇磷脂胆汁酸黏蛋白在胆囊结石结晶化过程中的作用  

Role of Cholesterol Phospholipid Cholic Acid and Mucoprotein in the Crystallization of Gallbladder Stone

作　　者：吴杰[1] 杨海珉[1] 周建莉[1] 田兴亚[2] 周明非[3] 

机构地区：[1]昆明医学院物理数学教研室,昆明650031 [2]昆明医学院生物化学教研室,昆明650031 [3]昆明医学院第二附属医院肝胆外科,昆明650101

出　　处：《生物医学工程学杂志》2007年第2期389-393,共5页Journal of Biomedical Engineering

基　　金：国家自然科学基金资助项目(39960024);云南省自然科学基金资助项目(1999C0064M);云南省教委科学基金资助项目(9912073)

摘　　要：分别用正常饲料、致石饲料饲养对照组和致石组豚鼠。在饲养过程中的不同阶段动态观测豚鼠胆囊胆汁中总胆固醇、黏蛋白、总磷脂和总胆汁酸含量的变化,并在偏光显微镜下观察各阶段结晶核的形成和结石晶体的生长情况。结果发现,对照组豚鼠胆囊胆汁中的总胆固醇、黏蛋白、总磷脂和总胆汁酸的含量在整个饲养过程中基本保持不变,且胆汁中未见有形结石晶体出现;而致石组豚鼠胆囊胆汁中总胆固醇和黏蛋白含量逐渐升高,总磷脂和总胆汁酸含量却逐渐降低,与对照组相比,饲养10 d后就有显著性差异,饲养25 d后就有显著性差异,且随着饲养天数的增加,致石组豚鼠胆汁中的液晶微泡增多变大并发生聚集和融合,以胆汁液晶微泡融合体为晶核的晶体生长迅速展开并最终形成大量微结石晶体。表明在胆囊结石形成过程中胆汁液晶是一种基本的结晶核,液晶微泡的聚集和融合是形成晶体生长的关键性因素。胆固醇和黏蛋白起到了促成液晶微泡产生聚集并相互融合的促成核作用,而磷脂和胆汁酸起到的则是抗成核作用。Normal feed and stone-leading feed were used respectively to raise guinea pigs in the control group and stone-causing group. The dynamic changes of total cholesterol, mucoprotein, total phospholipid and total cholic acid were measured during various raising periods. The formation of crystal nucleus and the growth of gallstone were studied under polarzing microscope. It was found that the contents of total cholesterol, mucoprotein, total phospholipid and total cholic acid in the gallbladder bile of control group were nearly the same during the whole feeding process, and no shaped stone crystal was formed. In the stone-causing group, however, the contents of total cholesterol and mucoprotein gradually went up and the contents of total phospholipid and total cholic acid gradually went down. After 10 days＇ feeding, significant difference was seen,and after 25 days＇ feeding, highly significant difference was noted. With the increase of feeding days, the liquid crystal vesicles in the bile increased, became bigger, gathered in strings, and then formed liquid crystal cells. The stone crystal growth along these nuclei of bile liquid crystal cells spread out rapidly, and the micro-crystal grains formed further in number. It was shown that, during the process of gallbladder stone formation, bile liquid crystal cells form a basic kind of nucleus, and the gathering and merging of bile liquid crystal vesicles be the key to crystal growth. So cholesterol and mucoprotein play the role of nucleation-leading factors in enhancing the gathering and merging of liquid crystal vesicles, and phospholipid and cholate play the role of anti-nucleation during the formation of gallbladder stone.

关 键 词：胆固醇 磷脂 胆汁酸 黏蛋白 胆囊结石 

分 类 号：R657.4[医药卫生—外科学]