胆汁酸代谢对胆固醇结石形成影响的研究进展  

Advances in effect of bile acid metabolism on cholesterol gallstone disease

作　　者：马先豪 孙岩波[1] 岑云云[1] 徐鹏远[1] Ma Xianhao;Sun Yanbo;Cen Yunyun;Xu Pengyuan(Department of Gustrointesinal Surgery,The Second Ailiated Hopital of Klunning Medical Univrsity,Kunning 650101,Yunnan,China)

机构地区：[1]昆明医科大学第二附属医院胃肠外科,云南昆明650101

出　　处：《肿瘤代谢与营养电子杂志》2023年第3期430-436,共7页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：云南省卫生健康委员会医学后备人才培养计划(H-2018067);云南省名医专项基金资助项目(YNWR-MY-2020-050)。

摘　　要：胆囊结石是消化系统的常见病、多发病,其中以胆固醇性结石最为多见,目前胆固醇结石的发生机制仍十分复杂,涉及胆固醇代谢、胆囊功能、肠道菌群、环境与遗传等多个方面,如何防治胆固醇结石成为临床研究的热点和难点。有研究发现补充亲水性胆汁酸类药物可预防和治疗部分胆囊结石,说明胆汁酸在胆囊结石的发生、发展过程中起着重要作用。胆汁酸是胆汁中重要的组成部分,它不仅参与人体脂质的消化吸收,同时作为胆固醇的代谢产物之一,对维持胆汁中胆固醇稳定和防止胆固醇结石形成具有重要意义。正常情况下,胆汁中胆固醇、磷脂、胆汁酸等3种有机成分保持着合理的比例,使胆固醇结晶不易沉积形成结石,而当胆汁酸的合成分泌、转运、摄取和重吸收等环节失调,均会导致胆汁酸池减少,胆汁稳态失衡,使胆固醇过饱和析出导致结石形成。此外,胆汁酸代谢紊乱,还会进一步导致胆囊功能障碍、肠道菌群失调从而加速胆固醇结石的形成。为进一步认识上述机制间的内在联系,现就胆汁酸代谢与胆固醇结石发病机制之间的关系及最新研究进展进行综述。Gallstones are a common and frequently ocurring digestive disease,with cholesterol stones being the most prewalent type.Intestinal flora,gallbladder function,environment,genetics,and cholesterol metabolism are just a few of the factors that play a role in the mechanism of cholesterol stones at this time.Clinical research on how to prevent and treat cholesterol stones has become a hot topie and callnge.According to sone studies,hydrophilie bile acid dnugs can help prevent and treat some gllstones,proving that bile acidis a key factor in the formation of gallstones.It is not only a erucial component of bile that aids in the breakdown and abeoption of human lipids,but it is also one of the cholesterol's metabolites.The stability of cholesterol in bile must be maintained in order to avoid cholestrl stones from developing.In bile,cholesterol,pboepholipid,bile aid,and other organic components tpcally remain in a reasonable ratio,preventing cholesterol crystals from easily depositing and forming stones.However,when bile acid synthesis,secretion,transport,uptake,and reabeoption are abnormal,bile acid pool will be reduced,bile homeostasis is unbalanced,and cholesterol oversaturation will precipitate and cause stone formation.In addition,bile acid metabolism poblems will worsen gallbladder problems,alter intestinal flora,and hasten the development of cholesterol stones.This paper reviews the relationship between bile acid metabolism and the pathogenesis of cholesterol stones and the most recent advances in research in order to better understand the intemnal relationship between the aforementioned mechanisms.

关 键 词：胆固醇结石 胆汁酸 代谢 

分 类 号：R575.62[医药卫生—消化系统]