胆囊结石与胆囊黏膜及胆汁幽门螺杆菌、磷脂酶A_2的关系

Relationship between Helicobacter pylori and phosphatidolipase A2 in gallbladder mucosa and bile and gallstone

目的探讨幽门螺杆菌(Hp)感染与胆囊结石形成之间的关系。方法PCR法和快速尿素酶法分别检测胆囊结石患者胆囊黏膜及胆汁Hp DNA和尿素酶,酸滴定法测定胆囊黏膜和胆汁磷脂酶A2(PLA2)活性,并做黏膜和胆汁普通、厌氧和Hp培养。结果黏膜Hp DNA阳性检出率45.24%,胆汁阳性检出率35.71%,其中胆汁Hp DNA检测结果阳性者,其黏膜检测结果均阳性。黏膜Hp DNA阳性组胆汁中PLA2的活性显著高于阴性组胆汁,分别为(480.92±164.21)U/L,(225.01±79.01)U/L;黏膜之间的PLA2活性差异无统计学意义(P>0.05)。黏膜及胆汁尿素酶检测均为阴性,普通、厌氧和Hp培养阴性。结论胆囊结石患者存在Hp感染因素,并可能通过PLA2促进胆囊结石形成。

Objective To investigate the relationship between helicobacter pylori infection and the formation of cholecystohthiasis. Methods The polymerase chain reaction （PCR） and rapid urease test were applied to examine the DNA of Helicobacter pylori and urea enzyme in the gallbladder mucosa and bile respectively. The activity of phosphatidolipase A2 in the gallbladder mucosa and bile was quantitatively determined by acidimetry. Regular, anaerobic and Hp cultures were performed for gallbladder mucosa and bile. Results The positive rate of PCR amplification in gallbladder mucosa and bile was 45.24 % and 35.71% respectively, The PCR in gallbladder mucosa was all positive while it was positive in the bile. The activity of phosphatidolipase A2 in the bile positive for Hp DNA （480.92±164,21） U/ L in the gallbladder mucosa was significantly higher than that negative for Hp DNA （225.01±79.01 ） U/L. There was no significant difference in the activity of phosphatidolipase A2 in the gallbladder mucosa. The ureasein gallbladder mucosa and bile was negative. The regular, anaerobic and Hp cultures were negative. Conclusion The patients with cholecystolithiasis have the Hp infection agents and the infection may accelerate the formation of cholecystolithiasis by enhencing the activity of phosphatidolipase A2 in the bile.