胆石病患者胆囊收缩素受体与胆囊动力关系的研究

Relationship between Cholecystokinin Receptor and Gallbladder Motility in Patients with Gallstones

研究胆囊平滑肌的胆囊收缩素-A受体(CCK-R)与胆囊动力的关系。方法:B超测定10例无胆石的正常者和33例胆囊结石患者的胆囊动力。采用放射配基法测定33例患者的胆囊和8例意外创伤死亡者正常胆囊中CCK-R含量和活性。根据无胆石正常者的胆囊残余指数,将胆石患者分为胆囊收缩“正常”组(14例)和收缩减弱组(19例),而将10例无胆石正常者和8例意外死亡者列为正常对照者。结果:收缩减弱组的CCK-R含量和活性都显著低于正常对照组(P<0.01),也显著低于收缩“正常”组。收缩“正常’组的CCK-R活性显著低于正常对照组(P<0.01),但含量与正常对照组无明显差异。CCK-R含量和活性分别与胆囊排空率相关(r=0.964,r=0.635,P<0.01)。结论:胆囊胆汁郁积在胆囊收缩“正常”组是由于胆囊空腹容积增加、胆囊CCK-R活性降低,在胆囊收缩减弱组是由于胆囊CCK-R含量和活性的降低。

To study the relationship between cholecystokinin-A receptor(CCK-R) in gallbladder and motility of gallbladder in patients with gallstones. Methods: Gallbladder motility was studied by ultrasonography in 33 gallbladder stone patients and 10 health subjects as controls. Radioligand me-thod was used to assay the gallbladder CCK-R for 33 gallstone patients with cholecystectomy and 8 pa-tients without gallstone died of severe trauma as controls. Based on the criterion of gallbladder residu-al fraction of the control group, 33 gallstone patients were divided into two subgroups, contractor (n= 14) and noncontractor (n=19). Results: The amount and activity of CCK-R were lower in the noncon-tractor subgroup than in both the control group and the contractor subgroup(P<0.01). The activity of CCK-R was lower also in the contractor subgroup than that in the control group(P<0.01), but there was no significant difference in amount of CCK-R. The amount and activity of CCK-R correlated close-ly with the postprandial gallbladder emptying(r=0.964, r = 0.635, P<0.01). Conclusions: It was suggested that gallbladder bile stasis may be due to the increase in gallbladder fasting volume and to the de-crease in activity of gallbladder CCK-R activity in the contractor subgroup, and to the decrease in the amount and activity of gallbladder CCK-R in the noncontractor group.