胆宁片对胆石症患者胆汁成分和成石趋势的影响

Effects of Danning tablet on the bile components and the lithogenic tendency in patients with cholelithiasis

目的研究胆宁片对胆石症患者胆汁成分和胆汁成石趋势的影响。方法将60例胆石症患者随机分成胆宁片组、熊去氧胆酸(UDCA)组及对照组,测定术中、术后胆汁总胆红素(TB)、直接胆红素(DB)、胆固醇(CH)、磷脂(PHL)和总胆盐(TBS)含量,并计算出各组应用成石指数(L.I.)、间接胆红素百分比(UCB%)和胆汁成石趋势综合值(Z值)的变化。结果术后第5天,3组间胆汁各成分及L.I.、UCB%、Z值的差异均无统计学意义(P值均>0.05),且Z值始终>临界值(44.7)。UDCA组、对照组术后第5天与术后第19天的胆汁各成分含量及UCB%、L.I.、Z值的差异均无统计学意义(P值均>0.05)。与术后第5天相比,胆宁片组术后第12天胆汁中CH含量明显下降(P<0.05),TBS和PHL的含量明显升高(P值均<0.05),UCB%明显降低(P<0.05);术后第19天,胆宁片组的UCB%、L.I.和Z值均明显下降(P值均<0.05),其中Z值<临界值。结论胆宁片具有调节胆汁成分的作用,从而抑制胆石形成的趋势。

Objective To study the influence of Danning tablet on the bile components and the lithogenic tendency in patients with cholelithiasis. Methods Sixty patients with cholelithiasis undergoing cholecystectomy were randomly divided into Danning tablet group, ursodeoxycholic acid（UDCA） group and control group, with corresponding medications after the operation. During and after operation, bile total bilirubin（TB）, direct bilirubin （DB）, cholesterol（CH）, phospholipid（PHL） and total bile salt（TBS） were measured for each patient, and the lithogenic index（LI）, percentage of unconjugated bilirubin（UCB%） and the Z value for estimating the bile lithogenic tendency were calculated. Results Five days after the operation, the contents of the bile components, UCB% LI and the Z value were not significantly different between the 3 groups（all P 〉 0.05）, and the Z value remained greater than the critical value（44. 7）. In UDCA group and the control group, the contents of the bile components, UCB%, LI and the Z value on day 19 after the operation exhibited no significant difference from the measurements on day 5（all P 〉 0.05）. In Danning tablet group, the CH level in the bile and the UCB% showed significant reduction; TBS and PHL exhibited significant increase on postoperative day 12（all P 〈 0.05） ; and on day 19, the UCB%, LI and the Z value were all significantly decreased（all P 〈0.05）, with a Z value below the critical value. Conclusion Danning tablet can modulate the bile components, and thus may reduce the tendency of gallstone formation.