胆囊胆固醇结石患者肝脏羧肽酶E表达

Expression of hepatic carboxypeptidase E in patients with gallbladder cholesterol calculus

目的分析胆囊胆固醇结石患者肝脏羧肽酶E(CPE)的表达,探讨胆囊胆固醇结石形成的可能机制。方法肝胆手术留取肝活检标本30例。其中,胆囊胆固醇结石20例(结石组),胆囊无结石患者10例(对照组)。利用qRT-PCR、蛋白免疫印迹法测定两组肝脏CPE表达,用ELISA法测定血清胆囊收缩素(CCK)表达;并测定血清总胆固醇及血清总三酰甘油含量,分析胆汁成分及胆固醇饱和指数(CSI)。结果结石组胆汁总胆固醇、胆汁总脂含量及CSI均高于对照组(P<0.05),结石组血清CCK、肝脏CPE mRNA表达及CPE蛋白表达均低于对照组(P<0.05)。结石组患者血清CCK含量与肝脏CPE mRNA表达呈正相关(r2=0.710,P<0.05)。结论肝脏CPE表达降低可能导致血清CCK分泌减少,进而诱发结石形成。

Objective To evaluate the expression of hepatic carboxypeptidase E（CPE） and investigate the underlying mechanism in the patients with gallbladder cholesterol calculus. Methods The expressions of hepatic CPE and serum cholecystokinin（CCK） were detected by qRT-PCR, Western blot,and ELISA in the patients with gallbladder cholesterol calculus（group A, 20 cases） and those without calculus（group B, 10 cases）. Serum levels of total triglycerides and total cholesterol were measured and bile and cholesterol saturation index were analyzed as well. Results Compared to group B, the levels of total cholesterol and total lipids in bile and CSI were higher, serum level of CCK and the expressions of hepatic CPE mRNA and protein were lower in group A（P〈0. 05）. Serum level of CCK was positively correlated to hepatic CPE mRNA expression in group A （r^2=0.710, P〈0. 05）. Conclusion Decreased expression of hepatic CPE might reduce the secretion of serum CCK, which may induce a formation of calculus in the gallbladder.