兔胆红素钙结石成石过程中血脂质变化的研究

Changes of Serum Lipoprotein Cholesterol in Rabbit Model of Calcium Bilirubinate Cholangiolithiasis

采用兔模型，测定兔在胆红素钙结石成石过程中全套血脂质以及胆汁中胆汁酸（ＢＡ）含量。结果发现：各实验组的血清高密度脂蛋白胆固醇及高密度脂蛋白２胆固醇均较对照组降低，除单纯胆道梗阻（ＢＯ）１周组外均有显著性差异（Ｐ＜０．０１）。血清游离胆固醇及高密度脂蛋白３胆固醇各组均显著高于对照组（Ｐ＜０．０１）。胆汁中总胆汁酸在梗阻感染（ＢＯＩ）１周组已明显减少并持续存在（Ｐ＜０．０５），６周时仅为对照组的２４．１９％。ＢＯ１周组胆汁中８Ａ已开始下降，但无统计学差异（Ｐ＞０．０５），至６周时仅为对照组的３０．８７％，降低显著（Ｐ＜０．０５）。以上结果表明：在胆道梗阻感染情况下，主要是高密度脂蛋白合成减少及成熟障碍，使肝细胞摄取并用于ＢＡ合成的高密度脂蛋白胆固醇减少，最终导致胆汁中ＢＡ含量下降。并在其他因素参与下共同导致色素性结石的形成。

The lithogenic process of cbolangi-olithasis is still not understood clearly. In this study,several serum lipoprotein cholesterol,the bile BA lev-el, etc.in the rabbit model of calcium bilirubinatecholangiolithiasis were examined. The main results in-cluded:(1)The concentrations of HDL-ch and HDL_2-ch in the serum decreased in all the experimentalgroups (P<0.0l; P<0.05),except HDL-ch in the BOIW group(P>0. 05 ) compared with the controlgroup.The concentrations of HDL_2-ch in the BOI 1Wand the BOI 6W groups were lower than those in theBO 1W and the BO 6W groups respectively(P<0.05 ); the both concentrations of Fch and HDL_3-ch inthe BOI and the BO groups were much higher thanthose in the control group (P<0.01).(2)The bile T-BA level was lower in the both BOI groups than thatin the control Broup(P<0.05). It began to decreasein the BO group during the first week ,but it was notsignificant in statistical difference(P> 0.05).Duringthe 6th week the level of the bile acid (BA)was muchlower than that in the control group(P<0. 05) Ac-cording to the above results , it may be concluded thatin the formation of calcium bilirubinate gallstones,caused by the biliary obstruction and infection, thereis a disorder in the lipoprotein metabolism. The maindisturbances of the lipoprotein metabolism obviouslyare in the mature process and decreased biosynthesis ofthe HDL,which can decrease the HDL-ch entering theliver cells,and make the precursor ch pool,used forthe BA biosynthesis, decrease. BA secreted from theliver cells into bile decreases.These factors togetherwith ot her lithogentic elements probably promote theformation of the caloium bilirubinate gallstones.