肝硬化患者血浆VIP、CCK水平与胆囊排空功能的关系

The relationship between plasma VIP、CCK and gallbladder emptying function in patients with hepatic cirrhosis

探讨肝硬化时血浆胃肠激素水平对胆囊运动的影响。用放免法测定肝硬化患者及对照者血浆血管活性肠肽 (VIP)和胆囊收缩素 (CCK)含量 ;用B超测定餐前、餐后胆囊容积及排空率。结果 :肝硬化时血浆VIP、CCK均明显增高 (P <0 0 1,P <0 0 5 ) ;胆囊空腹容积、剩余容积均明显增大 (P <0 0 1,P <0 0 0 1) ,最大排空率较对照组无明显差异 (P >0 0 5 ) ,但Child -PughC级降低 (P <0 0 5 )。肝硬化组胆囊最大排空率与VIP呈负相关 ,胆囊空腹容积及剩余容积与VIP均呈正相关 ,胆囊空腹容积、剩余容积及最大排空率与CCK均无相关。提示肝硬化时VIP增高既抑制胆囊运动 ,又明显降低胆囊张力 ,肝硬化时可能存在对CCK的抵抗。

To study the effects of gastrointestinal hormones on gallbladder emptying function in patients with hepatic cirrhosis. 20 patients with hepatic cirrhosis and 10 healthy controls were studied. Plasma VIP and CCK were measured with radioimmunoassay and gallbladder emptying function was measured by ultrosonography with fat meal test. The plasma VIP and CCK of patients were all higher than that of controls. Both the gallbladder's basal and residual volumes of patients were larger than that of controls. The maximal percentage of gallbladder emptying was not significantly different between cirrhotic and control group, but that of Child-Pugh C group was decreased. In cirrhotic group, the maximal percentage of gallbladder emptying was negatively correlated with VIP level, while the gallbladder's basal and residual volumes were positively correlated with it. None of above items was correlated with CCK level in cirrhotic group. The elevated VIP level in cirrhotic patients can decrease the tension of gallbladder apart from inhibiting the movement, and there were CCK resistance in cirrhotic patients.