单纯胆囊结石患者胆囊胆汁淀粉酶改变及其意义探讨  

Change and significance of the gallbladder bile amylase level in patients with cholelithiasis

作　　者：侯坤[1] 阎波[1] 艾尼瓦尔亚森 韩策然[1] 俞士勇[1] 朱琪[1] HOU Kun;Yan Bo;AINIWAER-YA Sen;HAN Ce-ran;YU Shi-yong;ZHU Qi(Department of General Surgery, People’s Hospital of Pudong District, Affiliated to Shanghai University of Medicine & Health Sciences Shanghai 201299, China;Department of Surgery, Shache People’s Hospital, Kashi, Xinjiang 844700, China)

机构地区：[1]上海市健康医学院附属浦东新区人民医院普通外科,上海201299 [2]新疆莎车县人民医院外科,新疆喀什844700

出　　处：《肝胆胰外科杂志》2017年第3期200-202,共3页Journal of Hepatopancreatobiliary Surgery

基　　金：上海市浦东新区卫生和计划生育委员会科技发展专项基金资助项目(PW2013A-5)

摘　　要：目的探讨单纯胆囊结石患者胆囊胆汁淀粉酶(amylase,AMY)的改变及其意义。方法影像学诊断明确的单纯胆囊结石患者50例,均行LC术,术中取胆囊胆汁3 mL,采用干化学法检测AMY,与血AMY比较,并对切除的胆囊行常规病理检查。结果 50例患者中胆囊胆汁AMY为30~3 020 U/L,平均(474.7±753.2)U/L,与血清AMY(64.3±17.1)U/L比,胆汁AMY明显升高(P<0.05)。其中胆固醇性结石19例,胆色素性结石14例,混合性结石17例,胆色素性结石组和混合性结石组均高于胆固醇性结石组的胆汁AMY(P<0.05)。腺肌症胆汁AMY水平高于非腺肌症的AMY水平(P<0.01)。结论胆囊结石患者存在胰胆反流,胆汁中AMY升高可能与结石形成及胆囊的病理学改变密切相关。Objective To evaluate the changes and significance of bile amylase level in patients with simple cholecystolithiasis.Methods Fifty patients with simple cholecystolithiasis by imaging diagnosis underwent the laparoscopic cholecystectomy(LC).Amylase level in gallbladder bile was detected by the dry chemistry method,then which was compared with the blood amylase level.Routine pathological examination was implemented in removed gallbladder.Results The mean bile amylase level in50patients was(474.7±753.2)U/L,ranged from30U/L to3020U/L,while the mean blood amylase level was(64.3±17.1)U/L,which was significantly lower than that in the bile(P<0.05).Among those objects,19cases was cholesterolgallstone,14cases was bile pigment stone and17cases was mixed stone.The bile amylase levels in bile pigment stone group and mixed stone group were significantly higher than that in cholesterol was gallstone group(P<0.05).The gallbladder bile amylase level in adenomyomatous hyperplasia patients was higher than that in non-adenomyomatous hyperplasia patients(P<0.01).Conclusion The ancreatic bile reflux exists in bile for patients with cholelithiasis.Possibly,the increase of bile amylase level closely associated with gallstone formation and pathological changes of gallbladder.

关 键 词：胆石症 胆汁淀粉酶 

分 类 号：R657.42[医药卫生—外科学]