血浆脂蛋白胆固醇水平与胆囊结石形成关系的实验研究

AN EXPERIMENTAL STUDY ON THE RELATIONSHIP BETWEEN PLASMA LIPOPROTEIN CHOLESTEROL AND GALLSTONE FORMATION

为研究兔胆囊结石成石过程中血浆脂蛋白胆固醇变化，及其对胆汁中胆汁酸、胆固醇含量及成石的影响，在用高胆固醇膳食（ＨＣＤ）致兔胆囊胆固醇结石模型基础上，将动物分为５组，每组１０只，动态监测成石过程中血浆脂蛋白胆固醇、总胆固醇（ＴＣ）、磷脂、甘油三酯、胆汁中胆汁酸及胆固醇含量的变化。结果：①随着喂饲ＨＣＤ时间增加，血浆ＴＣ、低密度脂蛋白胆固醇（ＬＤＬＣ）及极低密度脂蛋白胆固醇（ＶＬＤＬＣ）显著升高，３周组及４周组较对照组有显著性差异（Ｐ＜０．０５），而高密度脂蛋白胆固醇（ＨＤＬＣ）各组间虽无明显差别（Ｐ＞０．０５），但其转运血浆胆固醇的作用明显减弱（由对照组的８０．００％降至４周组的３．６８％）；②胆汁中胆固醇含量逐渐增加，３周组及４周组则明显增高（Ｐ＜０．０５），而甘氨脱氧胆酸（ＧＤＣＡ）及甘氨胆酸（ＧＣＡ）含量无明显改变（Ｐ＞０．０５）。本实验结果提示：血浆脂蛋白胆固醇所反映的脂蛋白代谢的变化，可能因影响体内的胆固醇及胆汁酸等代谢而与胆囊结石的形成密切相关，并可能在结石的形成中起重要作用。

To study of plasma lipoprotein cholesterol and effects of these changes on bile acids and cholesterol in bile during gallstone formation in rabbit model. This gallstone model was induced by high cholesterol diet (HCD). The rabbits were divided into five groups and there were ten animals in each group. The plasma high density lipoprotein cholesterol (HDL C) and its subgroups (HDL 2 C, HDL 3 C), low density lipoprotein cholesterol (LDL C), very low density lipoprotein cholesterol (VLDL C) , total cholesterol, triglyceride, phospholipid, bile acids and cholesterol of bile were investigated in different time. The results were as follow: ①As the time of feeding HCD passed by, the plasma total cholesterol, LDL C and VLDL C increased markedly (3 week group and 4 week group vs control group, P <0.05). Though the plasma HDL C and its subfractions HDL 2 C and HDL 3 C did not change significantly, the function of HDL in transporting plasma cholesterol decreased markedly (from 80.00% to merely 3.68%); ②Cholesterol in bile increased gradually and there were significant differences when 3 week group and 4 week group comparing with control group. The concentration of GDCA and GCA in bile changed slightly ( P >0.05). These results suggest that the changes of plasma lipoprotein cholesterol may affect the metabolism of cholesterol and bile acids and it may take an important role in the formation of gallstone.