胆囊结石症的血清脂质、瘦素、胆囊收缩素和胆脂水平分析  

Characteristics of serum lipids, leptin, cholecystokinin and bile lipids in patients with cholecystolithiasis

作　　者：金恩芸[1] 许国强[1] 徐根云[1] 陈洪潭[1] 单国栋[1] 杨铭[1] 沈岩[2] 胡凤玲[1] 吴益群[1] 

机构地区：[1]浙江大学医学院附属第一医院消化科,杭州310003 [2]浙江大学医学院附属第一医院肝胆科,杭州310003

出　　处：《中华消化杂志》2008年第4期237-241,共5页Chinese Journal of Digestion

摘　　要：目的探讨胆囊胆固醇结石患者血清脂质、瘦素、胆囊收缩素（CCK）和胆脂水平变化与胆囊胆固醇结石形成的关系及临床意义。方法按胆囊结石成分将患者分为胆固醇结石组（99例）和非胆固醇结石组（57例），测定该两组及正常对照组（52名）的血脂、脂蛋白、载脂蛋白（Apo）、瘦素、CCK水平和胆汁中胆固醇、磷脂和胆汁酸浓度，比较分析三组间血脂、胆脂、瘦素和CCK的水平差异。结果胆固醇结石组血清三酰甘油、总胆固醇和载脂蛋白B（Apo-B）均高于正常对照组（P值分别为0．000、0．002和0．017），非胆固醇结石组血清三酰甘油、总胆固醇明显高于正常对照组（P值分别为0．000和0．001）；两结石组患者的血清高密度脂蛋白与CCK均显著低于正常对照组（P值均为0．000）。男性患者血清瘦素水平显著高于正常对照组（P=0．016）。两组患者胆汁中的胆固醇饱和指数（CSI）均大于1。结论血清CCK、三酰甘油、胆固醇、高密度脂蛋白、Apo-B和瘦素水平变化可能与胆囊结石的形成有关。Objective To investigate the association of serum lipid, lipoprotein, apolipoprotein, leptin, cholecystokinin（CCK） and bile lipid with cholesterol gallstone formation. Methods The patients with gallstone were divided into cholesterol （n = 99 ） and non-cholesterol （ n = 57 ） gallstone groups by infrared spectometry. And 52 healthy volunteers were served as control group. The concentrations of serum cholesterol, triglyceride, high and low density lipoproteins, apolipoprotein（Apo）, leptin and CCK were measured and compared among three groups. The levels of total bile cholesterol, bile acid and lecithin were also detected. Results The concentrations of serum triglyceride and total cholesterol in two gallstone groups were higher than those in control group（P value all 〈0.01）. The level of Apo-B in cholesterol gallstone group was higher than that in control group （P= 0. 017）. While the concentrations of high density lipoprotein and CCK were significantly lower in two gallstone groups than those in control group（P value all =0. 000）. Serum leptin was higher in male patients compared to controls（P〈0.05）. The bile cholesterol saturation index in two gallstone groups was above 1. Conclusions The changes of serum CCK, triglyceride, total cholesterol, high density lipoprotein, Apo-B and leptin may be correlated to the formation of gallbladder gallstone.

关 键 词：胆石症 脂蛋白 瘦素 胆囊收缩素 

分 类 号：R686[医药卫生—骨科学]