视黄醇结合蛋白4对胆固醇结石形成的影响

Effect of retinol-binding protein 4 on formation of cholesterol gallstone

目的探讨视黄醇结合蛋白4(RBP4)对胆固醇结石形成的影响。方法 98例胆囊胆固醇结石患者(结石组)行腹腔镜下胆囊切除术,同时选取102例健康志愿者作为对照组。收集两组临床资料,检测血清RBP4水平,同时检测结石组胆汁RBP4水平。根据血清中位RBP4水平(7.61μg/ml)将结石组分为血清高RBP4亚组和血清低RBP4亚组,每个亚组49例;根据胆汁中位RBP4水平(6.91μg/ml)将结石组分为胆汁高RBP4亚组和胆汁低RBP4亚组,每个亚组49例。对患者进行随访,记录术后胆管结石发生情况。结果结石组血清RBP4和TC水平高于对照组(P<0.05)。中位随访时间为36.4个月。血清高RBP4亚组发生3例肝内胆管结石、1例肝内胆管结石合并胆总管结石,血清低RBP4亚组发生3例肝内胆管结石,两组胆管结石发生率无统计学差异(P>0.05)。胆汁高RBP4亚组发生6例肝内胆管结石、1例肝内胆管结石合并胆总管结石,胆汁低RBP4亚组发生1例肝内胆管结石,胆汁高RBP4亚组胆管结石发生率较高(P<0.05)。结论胆囊胆固醇结石患者血清RBP4水平较高,与胆固醇结石的形成密切相关,高胆汁RBP4水平患者更容易发生术后胆管结石。

Objective To investigate the effect of retinol-binding protein 4(RBP4) on the formation of cholesterol gallstone.Methods A total of 98 patients with cholesterol gallstone in the gallbladder(group A) underwent laparoscopic cholecystectomy.A total of 102 healthy people was selected as the control(group B).The clinical data were collected and serum RBP4 level was detected in two groups.The RBP4 level in bile was also detected in group A.According to the median level of serum RBP4(7.61 μg/ml),the patients in group A was divided into two subgroups of A1(high level of serum RBP4) and A2(low level of serum RBP4).According to the median level of RBP4 in bile(6.91 μg/ml),the patients in group A was divided into two subgroups of A3(high level of RBP4 in bile) and A4(low level of RBP4 in bile).The patients were followed up and the occurrence of postoperative cholelithiasis was recorded.Results Serum levels of TC and RBP4 were higher in group A than those in group B(P<0.05).The patients were followed up for a median time of 36.4 months.The hepatolithiasis happened in 4 cases and hepatolithiasis combined with choledocholithiasis was seen in 1 case in group A1 and hepatolithiasis in 3 cases in group A2,which was not different in groups of A1 and A2(P>0.05).The hepatolithiasis occurred in 6 cases and hepatolithiasis combined with choledocholithiasis was seen in 1 case in group A3 and hepatolithiasis in 1 case in group A4,which was different in groups of A3 and A4(P<0.05).Conclusion Serum RBP4 level is higher in the patients with cholesterol gallstone in the gallbladder,which is closely related to cholesterol gallstone formation.High RBP4 level in bile is more likely to cause postoperative cholelithiasis.