细菌在胆固醇结石形成中的作用研究  

EFFECTS OF BACTERIA ON CHOLESTEROL GALLSTONE FORMATION IN GALLBLADDER

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

出　　处：《中国现代医学杂志》2003年第3期4-7,共4页China Journal of Modern Medicine

基　　金：甘肃省中青年科学基金资助 (项目编号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 :用PCR技术扩增 34例胆囊结石病人胆汁细菌培养阴性的黏膜、结石内细菌DNA片段 ,并测定 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 (LPS)、超氧化物歧化酶 (SOD)和糖蛋白含量及它们之间的相关。结果 :结石扩增阳性为 2 8/34(82 .35 % ) ,大肠杆菌最多 (9/ 2 8) ;黏膜仅有 4例阳性 (11.75 % )。胆囊结石组胆汁中各指标的水平均明显高于对照组 (P <0 .0 1) ,且与糖蛋白显著相关 (P <0 .0 1)。LPS与 β -G、SOD显著相关 (P <0 .0 1)。多因素分析表明SOD、LPS对糖蛋白的影响最大。结论 :胆囊结石中存在细菌DNA片段 ;细菌可能由代谢产物 (β -G、LPS、SOD等 )影响糖蛋白的分泌 ,参与胆囊结石的形成。Objective:To determine the effects of bacteria on cholesterol gallstone formation. Methods:Bacteria DNA in gallbladder gallstones and mucosas from 34 patients with cholecystolithiasis and negative bile culture was amplified by polymerase chain reaction (PCR). Meanwhile the level and relation of β-glucuronidase (β-G), Endotoxin (LPS), superoxide dismutase (SOD) and glucoprotein in gallbladder bile of 50 cholecystolithiasis patients and 15 controls were determined. Results:Twenty-eight of 34 gallbladder gallstones yielded a PCR product (82.35%), Escheirchia coli was the most kind of bacteria with 9 positive (32.14%). However, only 4 of mucosas yielded bacteria DNA section (11.75%). All of the determined factors in cholecystolithiasis patients were much higher than those in the controls ( P <0.001). In gallstones group, there was serious difference between positive bile culture and the negative ( P <0.05～0.01) and there was obvious correlation with the levels of glucoprotein and other factors especially SOD and LPS ( P <0.01～0.001). Multiple linear regression analysis showed that SOD and LPS had the most obvious effects to glucoprotein. Conclusions:Cholesterol gallstones in gallbladder harbor bacteria. Bacteria have an important role in the formation of cholesterol gallstones. Glucoprotein secretion of bile may be affected by metabolic products (β-G?LPS?SOD,etc.) of bacteria.

关 键 词：细菌 胆固醇结石 结石形成 内毒素 超氧化物歧化酶 糖蛋白 

分 类 号：R575.62[医药卫生—消化系统]