胆囊结石形成的动力学机制

The kinetic mechanism of gallstone formation

目的 进一步探讨胆囊结石形成的动力学机制。方法 选用家兔 5 7只 ,随机分为5组 :(1)正常对照组 (13只 ) ,给予标准家兔饲料 ;(2 )高胆固醇组 (14只 ) ,给予含 1 2 %胆固醇的高胆固醇饲料 ;(3)高胆固醇 +消炎痛组 (10只 ) ,给予高胆固醇饲料加消炎痛 ;(4 )高胆固醇 +红霉素组(10只 ) ,给予高胆固醇饲料加能促进胆囊收缩的红霉素 ;(5 )高胆固醇 +动力散组 (10只 ) ,给予高胆固醇饲料加能促进胆囊收缩的动力散。结果 第 1至第 5组生成结石者分别为 0只、12只、4只、0只及 2只 ,第 2组动物胆汁中胆固醇和粘蛋白浓度、胆囊管阻力、胆总管压力均较第 1组显著增高(P <0 0 1) ,胆囊排空率下降 (P <0 0 1) ;第 3组胆汁粘蛋白浓度、胆囊管阻力、胆总管压力较第 2组显著降低 (P <0 0 5 )。第 4组和第 5组与第 2组相比 ,胆汁中粘蛋白含量及胆囊管阻力低 (P <0 .0 1) ,胆囊排空率高 (P <0 .0 5 )。结论 除胆汁成分异常外 。

Objective To probe into the kinetics of gallstone formation.Methods Fifty seven rabbits were divided into five groups: (1) normal control with standard fodder, (2)1 2% cholesterol was added into the fodder,(3)1 2% cholesterol plus indomethacin in the fodder,(4)1 2% cholesterol plus erythromycin,(5) 1 2% cholesterol plus Dong Li San, a Chinese herb compound. All animals were feed four weeks before measurement.Results Gallstone developed in 0 out of 13 in group 1, in 12 out of 14 rabbits in group 2, in 4 out of 10 rabbits in group 3, in 0 out of 10 in group 4, and in 2 out of 10 in group 5. Compared with that in group 1 rabbits in group 2 had higher level of cholesterol and mucin in bile,much higher common bile duct pressure and cystic duct resistance,much lower gallbladder emptying rate ( P <0 01). Group 3 showed much lower level of mucin in bile,common duct pressure and cystic duct resistance compared with those in group 2 ( P <0 05). Group 4 and group 5 showed much lower mucin in bile,cystic duct resistance and much higher gallbladder emptying rate than those in group 2 ( P <0 01). [WT5”HZ]Conclusion Besides abnormal bile components, impaired biliary dynamics mechanism especially gallbledder emptying impairment contributes to gallstone formation. Decreased gallbledder contractility may be the key factor responsable for impaired gallbledder empty.