Changes of gastrointestinal myoelectric activity and bile acid pool during cholesterol gallstone formation in guinea pig

It has been known that enterohepatic circulation of bile acids is essential for regular cycling of migrating motor complex （MMC）. An important component of the enterohepatic circulation is the active reabsorption of conjugated bile acids in the terminal ileum, with special reference to bile acid pool size that may be defined as the total mass of bile acids in the enterohepatic circulation. However, because of technical difficulties in measuring of bile acid pool size in human being, the role of the bile acid pool has little been investigated, and the exact mechanism of change in bile acid pool size has not yet been clear. Therefore, were there two changes of small intestinal motility and bile acid pool size in cholesterol gallstone patients？ and, if so, was there correlated relationship between both alterations require further investigation？

胆石体外调节人体胆汁的胆固醇结晶途径

背景:胆固醇结晶是胆石形成的一个必要步骤。尽管一些模拟胆汁研究显示,胆石表面与周围水相对于结晶形成过程中的胆固醇分子存在竞争关系;但相关研究尚未在人体胆汁中开展。方法:收集13例行腹腔镜胆囊切除术患者的新鲜胆汁,其中10例为胆固醇结石,3例为胆色素结石。再从其他2例患者收集小的胆固醇结石。应用偏光显微镜观察原始胆汁和超滤胆汁(加入或不加入胆石)中胆固醇结晶的形态,包括螺旋状和针状无水胆固醇结晶,以及片状和块状胆固醇单水结晶。分别于胆石加入胆汁前和加入21天后,称量胆石的重量。结果:在原始胆汁中加入胆石后,无水胆固醇结晶有减少的趋势,但块状胆固醇单水结晶显著增多。在超滤胆汁中加入胆石后,螺旋状结晶和针状结晶的形成有受抑趋势,而片状和块状胆固醇单水结晶数量显著增多。胆汁孵育21天后,胆石重量显著减轻,无论是原始胆汁(-4.5%61.6%,P=0.046)还是超滤胆汁(-6.5%61.5%,P=0.002)。来自胆色素结石患者的胆汁,在未加入胆石前是清亮的;但加入胆固醇胆石后,所有样本均早期出现片状和块状胆固醇单水结晶。结论:无论是在原始胆汁还是超滤胆汁中,加入胆固醇结石均可对胆固醇结晶途径产生重大影响,胆固醇单水结晶的数量增加,而无水胆固醇结晶的形成受抑。固态胆固醇结晶从胆石表面分离或可解释这一现象。