高胆固醇饮食对胆囊结石形成和胆囊运动的影响

The influence of high cholesterol diet on gallbladder calculus formation and gallbladder motility

目的探讨高胆固醇饮食(HCD)能否引起胆囊胆固醇结石和对胆囊运动的影响及其机制。方法用实体解剖、B超观察HCD组、正常对照组的胆囊成石情况;测定两组的胆囊运动功能;用放免法测定空腹及脂肪餐后血浆胆囊收缩素(CCK)水平;用比色法测定胆汁中胆固醇浓度;观察胆囊病理学改变。结果HCD组的胆固醇结石成石率、胆汁胆固醇浓度显著高于正常对照组(P<0.05);HCD组的脂肪餐后CCK水平、胆囊排空功能低于正常对照组(P<0.05);HCD组有9例出现胆囊炎症性病理改变;正常对照组仅1例出现黏膜水肿。结论高胆固醇饮食可以造成家兔的胆囊胆固醇结石,成石的原因可能与胆囊运动功能障碍、胆固醇代谢紊乱、血浆CCK水平降低、胆囊炎症以及它们之间的相互作用有关。

Objective To investigate whether high cholesterol diet (HCD) can cause gallbladder cholesterol calculus and to probe into the mechanism of its influence on gallbladder motility function. Methods Noumenon dissect and B-type ultrasonic apparatus was used to observe condition of gallbladder calculus formation in HCD group and normal control group; gallbladder motility function of the two groups were measured; radioimmunoassay was used to measure plasma CCK level in fast and 30min after fatty meal; colorimetry was used to measure cholesterol concentration in bile; and the pathologic changes of gallbladder specimen were observed. Results The gallbladder cholesterol calculus formation rate and cholesterol concentration in bile of HCD group was remarkably higher than that in normal control group (P<0.05). The CCK level after fatty meal and gallbladder emptying function of HCD group was lower than that in normal control group (P<0.05). Inflammatory changes occurred in 9 cases of HCD group while mucosa edema occurred in only 1 case of normal control group. Conclusion High cholesterol diet can cause rabbit gallbladder cholesterol calculus, which is probably closely related with gallbladder motility function obstacle, plasma CCK level decrease and gallbladder inflammation or synthetic action of these factors.