脓性胆管炎胆汁中糖、脂肪及微量元素含量的变化

Gluco, Lipometabolic and Trace Elements Alteration in Bile with Acute Purulent Cholangitis

作者对胆总管结石伴脓性胆管炎急诊胆道手术者及胆总管结石择期胆道手术者,术中及术后胆汁中糖、脂肪及某些酶和微量元素的含量进行了检测和比较,发现胆管化脓梗阻时,胆汁中乳酸和糖降低,而LDH活性增加,提示此时肝细胞糖异生及糖利用增加,伴肝细胞膜的破坏。同时胆汁中多数脂类物质含量升高,伴脂肪酸活性增强,而胆固醇下降,提示脂肪动员增强。Zn、Fe在脓性胆管炎时升高,而Cr下降,其机理不明。

Analysis was made of the gluco, lipo-metabolic materials and trace elementsin bile from patients. The specimens werecollected in 11 cases with acute purulentcholangitis and 13 cases of selective bili-ary surgery at both inter-operational time,at which the biles were got by needlingfrom the common bile duct, and post-operational time, at which the bile wasobtained from T tube drainage bile beforethe extraction of the T tube or dischargefrom hospital. It was found that lactic acid and glu-cose markedly decreased and LDH activi-ty increased in the cholangitis group atinter--operational time. Lifted hepatic gl-yconeogenesis and gluco-consumption andhepatic cellular damage were indicated.At the same time, most of the lipo-materials and lipase activity increased, ascompared with the selective group, whichshowed that lipolysis was encouraged andthat lipomaterials had flowed into thebile because of hepatic cellular damage.At the time of acute cholangitis, the Znand Fe in bile markedly increased but theCr in bile decreased, and the mechanismwas not clear.