细菌代谢产物在胆囊结石成石中的作用  

Effect of bacterial metabolic products on gallstone formation in patients with cholecystolithiasis

作　　者：王学军[1] 李玉民[1] 李世雄[1] 

机构地区：[1]兰州医学院第一附属医院普外科,甘肃兰州730000

出　　处：《中国普通外科杂志》2002年第2期76-79,共4页China Journal of General Surgery

基　　金：甘肃省中青年科学基金项目 (ZQ - 97- 0 2 0 )

摘　　要：目的　 探讨细菌在胆固醇结石形成中的作用。方法　 测定 5 0例胆囊结石病人和 15例对照组胆囊胆汁中 β -葡萄糖醛酸酶 ( β -G)、内毒素 (ET )、超氧化物歧化酶 (SOD )和糖蛋白含量及它们之间的相关性。结果　 胆囊结石组上述指标均明显高于对照组 (P <0 .0 1～ 0 .0 0 1)。上述指标结石组细菌培养阳性组均明显高于阴性组 (P <0 .0 5～ 0 .0 1) ,β -G ,ET及SOD均与糖蛋白有相关性 ,尤以SOD明显 (P <0 .0 0 1)。ET与 β -G (pH 6 .8)和SOD之间亦呈相关关系 ( P <0 .0 1)。多因素分析表明SOD与ET对糖蛋白的影响最大。结论　 细菌可能通过其代谢产物 ( β -G ,ET ,SOD等 )影响糖蛋白的分泌 。Objective To study the effect of bacteria on cholesterol gallstones formation. Methods The levels of β-glucuronidase(β-G),endotoxin(ET),superoxide dismutase(SOD), and glucoprotein of gallbladder bile were determined in 50 cholecystolithiasis patients and 15 nonbiliary disease patients,and the relations between the 2 groups patients were analysed.Results The levels of β-G,ET,SOD, and glucoprotein in gallbadder bile of patients with cholecystlithiasis were much higher than those of the control group(P< 0.001). In gallstones group, all of the factors mentioned above had obvious difference between positive and negative bile cultures of bacteria (P<0.05～0.01).There were correlations between the levels of glucoprotein and other parameters especially SOD and ET(P<0.01～0.001).There were also obvious correlations between ET and β-G(P<0.001) or SOD(P<0.01).Multiple linear regression analysis showed that SOD and ET were the most influencial factors to glucoprotein. Conclusions Bacteria play an important role in the formation of cholesterol gallstones; glucoprotein secretion of bile may be affected by the metabolic products of bacteria (β-G,ET,and SOD etc.).

关 键 词：胆结石 病因学 胆固醇 代谢 胆汁 化学分析 Β-葡萄糖醛酸酶 内毒素 超氧化物岐化酶 细菌代谢 

分 类 号：R575.62[医药卫生—消化系统] Q592.9[医药卫生—内科学]