摘要
肝内外胆管结石的发病率在国内达到4.1～51.6％,此病产生的各种并发症严重危害着病人的生命和健康。临床工作者多年来进行了卓有成效的研究,但对其病因和发病机理的认识尚未获得统一。我们对24例肝内外胆管结石病和7例非结石胆道疾患病人的胆石和胆汁中的几种主要成分行定量检测,并通过分析胆汁中有形成分变化与胆红素钙结石形成的关系,以期对胆红素钙结石的病因和机理作进一步探讨。材料和方法 1.对象随机选择临床诊断原发性肝内外胆管结石病人24例,男性11例,女性13例,最大年龄65岁,最小17岁,平均46.3岁。术中取出胆石目测按日本胃肠病学会拟定标准分类。非结石胆道疾患病人7例作为对照,男3例,女4例.平均年龄40.2岁。
Concentration or activity of several ultimal material elements of calculiand bile of clinical twenty-four ases f calcium bilirubinate calculi and sev-en cases of nongallstone biliary disease was determined with biochemical met-hod in laboratory. On operating the bile was collected from commen bile du-ct. Bacteriologic culture positive rate of alcium bilirubinate calculi group(CBG) was 100％, simple E. coli infectious ratio was 52.4％. This ratiois much more han the ratio of nongallstone group (NG). The concentra-tion of cholic acid and phosphatide in CBG is less than that n G; the conc-entration of bilirubin and activity of β-glucuronidase (β-GS) in CBG is morethan that in NG. fter operation the improved condition of these constitue-nts increase or decrease in NG is etter than those in CBG. In bili of BCG,concentration of cholic acid and unconjugated ilirubin UCB) had significantnegative correlationship (r=-0.6327 p<0.05), concentration of cholic cid ndactivity of β-GS had siganificant negative correlationship (r=-0.7893 P<0.01), oncentration of UCB and activity of β-GS had positive correlationship (r=0.6254 p<0.05). it is uggested that bile duct infection, activity of β-GSincrease, UCB volume increase and recipitation, produced UCB-calcium comp-lex or bilirubin multihold constraction, cholic acid olume change could be ult-imate pathogenesis of calcium bilirubinate calculus.
出处
《临床肝胆病杂志》
CAS
1989年第1期28-29,共2页
Journal of Clinical Hepatology
