影响胆固醇结石成核因素的研究

STUDY ON THE CAUSES OF NUCLEATION OF CHDLESTEROL CALCULUS

目的探讨胆固醇结石的成因。方法用Ｈｏｌａｎ方法测定胆汁的成核时间，胆汁脂质测定分别用三氯化铁显色法、硫酸—过氯酸消化法、磷钼酸比色法，胆固醇饱和度计算由Ｃａｒｅｇ表查出，胆汁总蛋白和载脂蛋白Ａ－Ｉ分别用考马斯亮蓝蛋白法和免疫透射法检测。结果胆固醇结石成核时间较胆色素结石和外胆囊结石明显缩短，胆固醇结石成核时间与胆固醇饱和度无相关性，成核时间缩短患者胆汁中总蛋白浓度明显增加，而载脂蛋白Ａ－Ｉ浓度降低。结论胆固醇结石成核时间明显缩短，成核时间长短与胆固醇饱和度无关，胆汁总蛋白浓度增加可促进胆固醇结石的形成，而载脂蛋白Ａ－Ｉ可抑制胆固醇结石的形成。

Objective To study the causes of nucleation of cholesterol calculus. Methods Nucleation time (NT) was measured with Holan method. Biliary lipin was measured with FeCl3 coloration and H2SO4-HClO3 indigestive method. Cholesterol saturation was found in carey graph. The total protein amount and aprolipo protein A-I amount in the bile were measured with CBG method and radioimmuoassay, respectively.Results The NT of cholesterol calculus was shorter than that of bile pigment calculus or that of cholelithiasis cholecystolithiasis. There is no relationship. between the NT of cholesterol calculus and the cholesterol saturation. In those patients whose NT was shorter, the total protein amount increased while the aproliopo protein A-I amount decreased. Conclusion There is no relationship. between the length of NT and cholesterol saturation. If the total protein concentration increases, the formation of cholesterol caculus will be accelerated while if the aprolip protein increases the formation of chotesterol calculus will be inhibited.