微创保胆取石前后血脂、血瘦素及胆囊收缩素水平的变化  

Variations of serum lipids, leptin and cholecystokinin after the minimally invasive surgery of gallbladder-preserving cholecystolithotomy

作　　者：许焕建[1] 任培土[1] 邵惠江[1] 郑专[2] 

机构地区：[1]浙江省绍兴市人民医院肝胆外科,浙江绍兴312000 [2]浙江省绍兴市人民医院中心实验室,浙江绍兴312000

出　　处：《中国内镜杂志》2016年第1期15-18,共4页China Journal of Endoscopy

基　　金：绍兴市科技计划项目(No:2012B70076)

摘　　要：目的检测保胆取石手术前后血脂、血瘦素(Leptin)及胆囊收缩素(CCK)水平的变化,并探讨其与术后结石复发的关系。方法选取保胆取石手术患者30例作为研究组,并以同期无胆囊结石的健康患者30例作为对照组。测定研究组术前及术后血脂、Leptin及CCK水平,分析上述指标的差异,并分别与健康对照组作比较。结果保胆组患者术后血清高密度脂蛋白(HDL)低于术前水平(P=0.001),而血清总胆固醇(TC)、血清三酰甘油(TG)、低密度脂蛋白(LDL)与术前差异无统计学意义(P值分别为0.068、0.873和0.097);术后血Leptin和CCK低于术前水平(P值分别为0.000和0.000)。保胆组患者术前血TG高于正常对照组(P=0.025),而TC、LDL和HDL与正常组差异无统计学意义(P值分别为0.842、0.846和0.330);保胆组患者术前血Leptin和CCK高于正常对照组(P值分别为0.002和0.000)。保胆组患者术后血TG高于正常对照组(P=0.009),HDL低于正常对照组(P=0.000),而TC与LDL差异无统计学意义(P值为0.312和0.384);术后患者血Leptin与正常对照组差异无统计学意义(P=0.953),血CCK仍高于对照组,差异具有统计学意义(P=0.005)。结论保胆取石术后血Leptin和血CCK水平较术前明显降低,对于预防术后结石复发具有重要意义;术后血HDL较术前明显降低,而TC、TG和LDL无明显改变,说明保胆术后低脂饮食和增加适当锻炼,仍是预防结石复发的重要手段。Objective Detect the serum lipids, leptin and cholecystokinin（CCK） before/after the minimally invasive surgery of gallbladder-preserving cholecystolithotomy（MISGPC）, to reveal the variations and discuss the relations between the variations and the postoperative recurrence of gallstones. Methods Choose 30 patients who underwent the MISGPC for the research group（RG） and 30 healthy persons for the normal control group（NCG）.Detect the concentrations of the serum lipids, leptin and CCK before/after the MISGPC, analyze the diversity, and compare with the NCG. Results The postoperative concentrations of HDL, leptin and CCK are lower than the preoperative levels（P = 0.00, 0.000, 0.000）, the levels of TC, TG and LDL are no differences between pre and post operation（P = 0.068, 0.873, 0.097）. The preoperative concentrations of TG, leptin and CCK are higher than the NCG（P = 0.025, 0.002, 0.000）, the levels of TCH, LDL and HDL are no differences between the preoperative RG and the NCG（P = 0.842, 0.846, 0.330）. The postoperative concentrations of TG and CCK are higher than the NCG（P =0.009, 0.005）, the postoperative level of HDL is low than the NCG（P = 0.000）, the levels of TCH, LDL and leptin are no differences between postoperative RG and the NCG（P = 0.312, 0.384, 0.952）. Conclusions The concentrations of serum leptin and CCK are significantly reduced after the MISGPC, this fact is very meaningful for preventing the recurrence of gallstones after surgery. The concentration of HDL is reduced postoperatively, but the levels of TCH,TG and LDL do not vary significantly, this indicates that low fat diet and physical training are very important to prevent the recurrence of gallstones after the MISGPC.

关 键 词：保胆取石术 瘦素 胆囊收缩素 血脂 

分 类 号：R657.42[医药卫生—外科学]