胆管结石患者Oddi括约肌中胆囊收缩素受体和一氧化氮合酶及其血中胆囊收缩素和一氧化氮水平的意义

Changes and significance of the contents of cholecystokinin acceptors and nitric oxide synthase in Sphincter of Oddi and the contents of cholecystokinin and nitric oxide in the blood of patients with calculus of bile duct

目的探讨胆管结石患者Oddi括约肌中胆囊收缩素（CCK）受体和一氧化氮合酶（NOS）及其血清中CCK和NO含量的改变及意义。方法测定41例胆管结石患者和6例对照组血中的CCK和NO水平及Oddi括约肌中CCK受体和NOS含量。结果胆管结石组血中CCK含量[（38．91±4．85）pmol／L]、NO含量[（40．84±4．74）pmol／L]较对照组[（30．67±1．81）pmol／L]和[（32．81±1．11）pmol／L]明显升高；Oddi括约肌中CCK受体[（67．59±5．87）ng／L]及NOS含量[（457．52±45．40）ng／L]明显低于对照组[（78．99±1．71）ng／L]与[（519．61±11．38）ng／L]；血中CCK、NO水平及Oddi括约肌中CCK受体、NOS含量在原发性肝内胆管结石组、胆囊结石伴胆管结石组、原发性胆总管结石组中有所不同。结论胆管结石患者Oddi括约肌中CCK受体及NOS含量下降导致Oddi括约肌功能下降，进而胆汁淤积，促进胆管结石的形成。

Objective To investigate the changes and significance of the contents of cholecystokinin （CCK） acceptors and nitric oxide synthase （NOS） in sphincter of Oddi and the contents of CCK and nitric oxide （NO） in the blood of the patients with calculus of bile duct. Methods The contents of CCK acceptors and NOS in sphinctei of Oddi and the contents of CCK and NO in the blood were determined in 41 patientswith gallstone and 6 controls. Results The contents of CCK and NO in the blood of patients with gallstone were significantly higher than that in control[ （38.91±4.85 ） pmol/L vs （ 30.67± 1.81 ） pmol/L ; （ 40.84 ±4.74 ） pmol/L vs （ 32.81 ± 1.11 ） pmol/L] ;The contents of CCK acceptors and NOS in sphincter of Oddi in the patients with gallstone were signifi- cantly lower than in the controls [ （67.59 ± 5.87 ） ng/L vs （ 78.99 ± 1.71 ） ng/L; （457.52 ± 45.40 ） ng/L vs （519.61 ±11.38 ）ng/L] ;The contents of CCK and NO in the blood in the different groups with calculus of bile duct were significantly different from those in the controls. Coulcusion The degree of the decrease of the contents CCK acceptors and NOS in sphincter of Oddi leads to the decrease of Oddi sphincter function, resuting in cholestasis and promoting the formation of bile duct stone.