重视胆石病的胆囊病理机制研究  

Insights on the role of gallbladder in cholelithiasis

作　　者：蒋兆彦[1] 吴健[1] 韩天权[1] 张圣道[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院外科上海消化外科研究所,上海200025

出　　处：《腹部外科》2015年第5期299-301,共3页Journal of Abdominal Surgery

基　　金：国家自然科学基金（81270537）

摘　　要：胆囊胆固醇结石病（简称胆石病）是国内外常见病.保留胆囊取出结石的治疗对象应当是胆囊功能正常的胆石病病人,改良B超三维胆囊功能检查是选择治疗对象的有效方法.胆囊黏膜调节胆汁胆固醇饱和度,胆囊分泌黏蛋白促进成核以及胆囊收缩和舒张功能障碍,表明胆囊参与胆石形成的整个机制.影响胆囊动力的因素除了胆囊收缩素外,还有成纤维细胞生长因子15/19、G蛋白偶联胆汁酸受体等.深入探讨胆囊病理机制,对于胆石病防治的临床研究和发病机制的基础研究都有重要意义.Gallbladder cholesterol stone disease is a worldwide disorder. The cholecystotomy for gallbladder stone should be based on normal contraction of gallbladder tested by modified B type ultrasound examination of gallbladder volume with three dimensional measurements, which is based on the sum-of-cylinders method. Gallbladder mueosa can regulate the saturation of cholesterol in bile. Mucin glycoprotein secreted from gallbladder accelerates nucleation of cholesterol monohydrate crystals. Defects in gallbladder contraction and relaxation are found in the patients with gallbladder stones. Therefore, all the three defects in secretion, nucleation and motility of gallbladder are involved in the formation of cholesterol gallstone. The factors that affect gallbladder motility, such as cholecystokinin, fibroblast growth factor 15/19, G protein-coupled bile acid receptor and others, were studied. Further studies on the role of gallbladder in gallstone disease would be warranted both in understanding the formation of gallstones and in the clinical prevention and treatment of gallstone disease.

关 键 词：胆囊 胆石病 胆固醇 发病机制 

分 类 号：R657.42[医药卫生—外科学]