胆汁免疫球蛋白与胆固醇单水结晶形成的关系

The relationship between human biliary immunoglobulins and the formation of cholesterol monohydrate crystals

目的 :研究免疫球蛋白浓度与胆汁成核活性的关系。方法 :应用透射电子显微镜和酶联免疫吸附法对 32例胆囊结石病人和 2 2例正常对照组的胆囊胆汁进行观察及检测 ,以了解胆固醇结石组、胆色素结石组及对照组的胆固醇单水结晶 ( CMC)形成过程同免疫球蛋白 Ig A、Ig G、Ig M浓度之间的关系。结果 :胆固醇性胆囊结石组胆汁中形成 CMC,色素性胆囊结石组及对照组始终没有CMC的形成 ;胆固醇性胆囊结石组病人胆囊胆汁中 Ig M、Ig G浓度高于色素性胆囊结石组及对照组 ,尤以 Ig G明显 ( P<0 .0 0 1 ) ,三组胆汁中 Ig A浓度差异无显著性 ( P<0 .0 5 ) ;胆汁中 Ig G浓度与胆固醇单水结晶形成时间呈负相关 ( r=- 0 .899,n=2 5 ,P<0 .0 0 1 )。结论 :胆汁中作为促成核因子的 Ig G浓度升高可使 CMC形成时间缩短 ,其成核活性具有剂量效应关系。免疫球蛋白的增加可促进 CMC形成 ,它与胆囊胆固醇结石形成有一定的关系。

Objective: In order to study the relation between human biliary Igs and the formation of cholesterol monohydrate crystals (CMC). Methods: Transmission electron microscopy and the ELISA were used to examine the bile from 32 patients with cholecystolithiasis and bile from 22 controls for detecting the relationship between the formation process of CMC and the concentration of Igs (IgA,IgG,IgM). Results: The formation of CMC was only found in biles of the patients with cholesterol calculi. The biliary IgG,IgM concentration in the cholesterol gallstone group was significantly greater than the pigmented gallstone group and the control patients ( P <0 001). There was no significant difference in biliary IgA ( P >0 5) . There was a close negative correlation between the biliary IgG and CMC formation time ( r=-0 899, n=25 ,P <0 001). Conclusion: Increase of biliary IgG concentration can shorten the CMC formation time and functions in a dose response manner. The biliary immunoglobulin as a pronucleating protein may accelerate the CMC formation therefore,is related with development of cholesterol gallstone.