血浆神经降压素测定在胆石症时的临床意义

Clinical Significance of Plasma Neurotensin Determination on Chololithiasis

目的 探讨血浆NT测定的意义及其临床价值。方法 研究对象分为正常对照组和胆囊结石病人组 ,正常对照组再分为五个年龄组。受试者空腹静脉取血两次 ,然后进行试验餐 ,餐后第 15min、30min、60min、12 0min各取血一次 ,分离血浆 ,采用放射免疫分析法测定血浆NT值。结果 67名正常人空腹血浆NT值 ,试验餐后明显升高 ,其血浆NT反应曲线出现两次高峰 ,2 0 -4 9岁组于餐后 15min出现最高峰 ,而 5 0岁以上组在餐后 30min出现最高峰 ,两者的峰水平差值相差非常显著。 2 3名胆石症患者空腹血浆NT值为 15 39± 1 94pmol/L ,试验餐后血浆NT值均显著大于基础水平 ,其血浆NT反应曲线与正常人 5 0岁以上组相似。正常人与胆石症患者血浆NT组比较 ,空腹及餐后各时间点血浆NT值均无显著差异 ,但有二分之一的病人餐后第二峰值显著大于对照组。结论 脂肪对神经细胞直接刺激是NT释放的重要因素和条件 ,但不是唯一的 ;神经系统可能参与调节引起餐后早期NT浓度升高的反应 ,血浆NT浓度升高可能是部分患者之胆石形成的重要因素。

Aim To investigate the clinical significance of plasma neurotensin determination (NT) on chololithiasis.Methods The objected people were divided into a chololithiatic patient group and a normal control.The normal control group was further divided into five groups according to age. Venous blood of all studied people was taken out two times on fast. Then the studied people ate standard food.After meal they were taken out their venous blood four times in the 15th, 30th,60th and 120th minute. The plasma was separated and NT was determined using radioimmunological assay(RIA).Results The plasma NT of 67 normal persons on fast was 16 14±2 19 pmol/L and increased markedly after meal. Two peaks in the plasma NT reaction curve were found after meal. The first peak appeared at the 15th minute in the 20-49 ages group and at the 30th minute in the age group over 50.The difference between the values of the first peak of these two groups was very significant. The plasma NT of 23 chololithiatic patients on fast was 15.39±1.94 pmol/L and increased markedly after meal,somewhat similar as the age group over 50. The plasma NT in every tested time spots had no obvious difference in chololithiatic patient group and in normal control group. But the 2nd peak value in more than half patients was higher significantly than that in the control group of same age.Conclusions The direct stimulation of fat on N-cells is the important factor or condition of the release of NT, but not the only one. The developed reaction of early increased plasma NT is probably the result of regulation of factors of neural system. The increased plasma NT may probably be the part of the important factors of chololithiasis and the gall stone formation.