胆囊结石病人成纤维细胞生长因子-19的血浆含量及胆囊黏膜表达特点

Fibroblast growth factor-19 in gallstone patients:plasma content and expression of gallbladder mucosa characteristics

目的：检测胆囊结石病人成纤维生长因子-19（fibroblast growth factor-19，FGF-19）的血浆含量及其在胆囊黏膜的表达量．探讨FGF-19与胆囊舒张收缩功能的关系。方法：对27例胆囊结石病人（男9例，女18例，平均年龄48．5岁1。采用实时定量PCR法检测胆囊黏膜彤F-19mRNA的表达量。采用酶联免疫吸附法测定空腹及脂餐后1．5h、3．0h血浆FGF-19的含量。B超检查胆囊收缩功能。结果：按脂餐后1．5h胆囊排空率（ejectionfraction．EF）将胆石病人分为胆囊收缩正常组fEF〉60％，n=5），收缩减弱组[EF（30～60）％，n=15]和未收缩组（EF〈30％，n=7），3组餐后1．5h的胆囊EF分别为（67．2±3．4）％，（48．2±2．4）％和（17．0＋3．5）％，P〈0．01。收缩正常组的胆囊再充盈率[（82±12）％1大于收缩减弱组与未收缩组[（37±11）％和（7±71％1，P=O．006。未收缩组的胆囊黏膜凡；F-19mRNA表达量（130±711显著低于收缩正常组与收缩减弱组（222±82，254±50），P〈0．05。未收缩组空腹血浆FGF．19含量[（62．1±20．O）pg／mL]显著低于其他两组『收缩正常组（157．9±22．3）pg／mL，收缩减弱组（175．8±25．6）pg／mL]，P〈O．05。结论：部分胆石病人存在胆囊收缩和舒张功能障碍。血浆FGF-19含量变化可反映胆囊收缩和舒张功能异常。

Objective To evaluate the relation between fibroblast growth factor （FGF）-19 and gallbladder motility function by measuring the serum level of FGF-19 and the expression of FGF-19 mRNA in gallbladder mucosa from patients with gallstone disease. Methods Nine male and 18 female patients with gallstone disease were recruited. FGF- 19 mRNA expressions in gallbladder mucosa were determined by real-time PCR. Plasma FGF-19 level at fasting, 1.5 h and 3.0 h after fat diet were assayed by ELISA, the gallbladder volume at the corresponding time points were measured by B-type ultrasonic scanning. Results According to gallbladder ejection fraction （EF） at 1.5 h after fat diet, the patients were divided into 3 groups. For normal contraction group （EF 〉 60%, n= 5）, low contraction group [EF （30 - 60）%, n=15] and non contraction group （EF 〈 30%, n=7）, EF at 3.0 h after fat-diet were （67.2±3.4）%, （48.2±2.4）%, and （17.0±3.5）%, respectively, P 〈 0.01. Gallbladder refilling rate in normal contraction group （82＋-12）% was higher than low contraction and non contraction group [（37±11）% and （7±7）%], P = 0.006. FGF-19 mRNA expression in gallbladder mucosa was significantly lower in the non contraction group （130±71） than in the normal contraction group and the low contraction group （222±82 and 254±50）, P〈0.05. Fasting plasma FGF-19 level in non contraction group [（62.1±20.0） pg/mL] was lower than the other groups[normal contraction group：（157.9±22.3） pg/mL], low contraction group： [（175.8±25.6） pg/mL], P〈 0.05. Conclusions Gallbladder contraction and refilling function were impaired in subgroups of the gallstone patients. Changes of plasma FGF-19 level may reflect the abnormalities of gallbladder contraction and refilling.