肝细胞膜高密度脂蛋白受体在兔胆红素结石成石过程中的变化

Changes of HDL-receptor of Hepatic Cell Membrane in Rabbit Model of Calcium Bilirubinate Cholangiolithiasis

采用兔胆红素结石模型，测定在胆道梗阻与感染胆红素钙结石成石过程中，肝组织脂质含量及肝细胞膜高密度脂蛋白（ＨＤＬ）受体的变化。结果发现：肝细胞膜ＨＤＬ受体Ｂ＿（ｍａｘｄ）于１周时胆道梗阻（ＢＯ）及胆道梗阻感染（ＢＯＩ）组即已降低，与对照组比较差异显著，分别为对照组的６９．０９％和４９．０９％（Ｐ＜０．０１）。６周时，ＢＯ和ＢＯＩ组分别维持在１周时水平。Ｋｄ值１周时ＢＯ和ＢＯＩ组与对照组无差异（Ｐ＞０．０５），至６周时，ＢＯ和ＢＯＩ组均明显高于对照组（Ｐ＜０．０５）。肝组织游离胆固醇各实验组均较对组照减少（Ｐ＜０．０１）。我们认为：在胆道梗阻与感染条件下，肝细胞膜ＨＤＬ受体功能存在异常，早期主要是受体数目减少，后期存在亲和力降低。因受体功能障碍，使肝细胞摄取ＨＤＬ减少，从而减少了用于胆汁酸合成的游离胆固醇量。可能最终引起胆汁酸合成减少，促进色素性结石的形成。

HDL-receptor of the hepatic cell mem-brane and Fch level of the hepatic tissue in the rabbitmodel of calcium bilirubinate cholangiolithiasis wereexamined. The results showed:( 1)the HDL-receptors'B_(max) of the biliary obstruction and infection(BOI)andbiliary obstruction ( BO ) groups decreased during thelst vveek after operation(P< 0.01 );they were only69; 09%and 49. 09%of that in the control group re-spectively,and the lowered level cont inued untiI the6th week;the Kd values of BOI and BO groups werenot different from that of the control group during thelst week,but they were significantly higher in the 6thweek after operation(P<0.01);(2)the Fch levels ofthe hepatic tissue were slightly decreased in all experi-mental groups(P<0.05 ).We concluded that underthe conditions of biliary obstruction and infection.there was a disorder of the HDL receptors of hepaticcell membrane,At the early stage of biliary obstruc-tion and infection,the receptors decreased in number,and at the later stage,the affinity changed and lessHDL entered into the hepatic cell. Then the precursercholesterol pool for BA biosvnthesis narrowed.Thus,BA secreted from the liver cells into genetic elementspossibly promote the formation of the calcium bilirubi-nate gallstones.