单结合胆红素与胆固醇成核关系的初步探讨  

A study on the interaction of monoconjugated bilirubin with the nucleation of cholesterol

作　　者：涂向群[1,2] 萧荫祺[1,2] 祝学光[1,2] 许红兵[1,2] 李为民 刘玉京[1,2] 

机构地区：[1]解放军第三○九医院肝胆外科 [2]北京医科大学人民医院

出　　处：《中国普通外科杂志》1997年第6期334-336,共3页China Journal of General Surgery

摘　　要：在制备出大量较为纯净的单结合胆红素的基础上，对５８例胆囊结石（胆固醇结石３８例、色素性结石２０例）和１８例非胆囊结石患者胆囊胆汁中３种不同比例的ＭＣＢ对胆固醇成核时间的影响进行比较，结果：胆固醇结石患者胆汁中胆固醇成核时间分别为：４３０±２．１７天、３５５±１９５天和２５０±１５６天；色素性结石患者胆汁中分别为：８３０±２５２天、７４５±１９０天和６９５±２３５天；非结石患者胆汁中分别为：７８３±２７８天、５７８±２０７天和４５６±２０４天。胆固醇结石和非结石患者胆汁中随ＭＣＢ比例的增加，胆固醇成核时间显著地缩短（Ｐ＜０．０１）；而色素性结石患者胆汁中ＭＣＢ比例的增加对胆固醇成核时间无显著影响（Ｐ＞０．０５）。提示ＭＣＢ有促胆固醇成核的倾向；可能在胆固醇结石形成的早期起一个始动因子的作用。Seventy six gallbladder bile samples (38 patients with cholesterol stones, 20 with pigment stones and 18 without gallstones) were collected, three aliquots of each bile sample were divided into A,B and C groups, and the same amount of aqueous buffer solution, 279μmol/L MCB solution and 558μmol/L MCB solution were put in the three group samples respectively. Nucleation time (NT) of each group was observed, the results were as follows:(1) In cholesterol stone cases the NT with A,B and C groups was 4.30±2.17 days, 3.55±1.95 days and 2.50±1.56 days; in the cases without gallstones it was 7.83±2.78 days, 5.78±2.07 days and 4.56±2.04 days. The results indicated that the more concentration of MCB in the bile, the shorter time of NT; they showed a shorter time with the increasing consistency of MCB. (2) In pigment stone cases the NT in A,B and C groups had no markable difference (8.30±2.52 days, 7.45±1.90 days and 6.95±2.34 days). The results suggest that MCB may have an effect of promoting cholesterol nucleation; and MCB may be as a Start factor in the early stage of cholesterol gallstone formation.

关 键 词：单结合胆红素 胆固醇 成核时间 胆结石 

分 类 号：R364.25[医药卫生—病理学] R657.42[医药卫生—基础医学]