急性病毒性肝炎患者胆囊排空功能研究

Study on gallbladder emptying function in patients with acute viral hepatitis

目的研究急性病毒性肝炎（ＡＶＨ）患者胆囊（ＧＢ）排空功能及其与病情程度和转归的关系．方法用实时超声研究了３２例ＡＶＨ患者及２６例健康对照者ＧＢ排空功能．结果空腹ＧＢ容量（ＦＧＶ）ＡＶＨ患者（１０２２±２３１）明显小于对照组（１９７９±１５１）（Ｐ＜０００１），随病程延长，ＦＧＶ渐增多．ＦＧＶ减少与病情程度呈显著负相关（Ｐ＜００５）．餐后ＧＢ排出量（ＧＥＦ）ＡＶＨ组显著少于对照组（Ｐ＜０００１），其减少与病情程度呈明显负相关（Ｐ＜００１），与血清胆红质、ＡＬＴ水平呈显著负相关（Ｐ＜００５～００１）．６０ｍｉｎ最大ＧＥＦ及ＧＢ排空速度明显减少、减慢（Ｐ＜０００１）．恢复期ＦＧＶ及餐后ＧＥＦ均恢复正常．结论ＡＶＨ患者存在ＦＧＶ和餐后ＧＥＦ异常．其机制与肝细胞损害，泌胆功能障碍及神经—激素调控失调有关．

AIM To study gallbladder (GB) emptying function and its relationship with the severity of the disease and prognosis in patients with acute viral hepatitis (AVH). METHODS Thirty two patients with AVH and 26 normal controls were studied with real time ultrasonography. RESULTS Fasting GB volume (FGV) was less in AVH patients than in controls ( P <0 01). A markedly negative correlation was found between the decrease of FGV and the severity of the disease ( P <0 05). Postprandial GB ejection fraction (GEF) was decreased more significantly in AVH patients than in controls ( P <0 001), with a notably negative correlation between the decrease of GEF and the severity of the disease ( P <0 01). The FGV and postprandial GEF were increased with improvement of liver function, and up to normal level in the healing of AVH. The speed of GB emptying was slower and the maximum GEF was less in AVH patients than in controls ( P <0 01). CONCLUSION FGV and postprandial GEF decreased significantly in patients with AVH; reduced FGV may be related to decreased biliary excretion from the liver; and AVH patients may have an abnormal modulation of fatty meal CCK GB contraction/relaxation of Oddi sphincter.