摘要
目的探讨胆汁酸代谢异常与肝硬化并发胆囊结石的关系。方法选取2015年4月~2017年5月我院收治的肝硬化并发胆囊结石患者40例(研究组)、单纯胆囊结石患者36例(对照组)为研究对象,均于术前1d采血检测血清生化指标[总胆红素(TBIL)、直接胆红素(DBIL)、总胆固醇(TC)、甘油三酯(TG)、总胆汁酸(TBA)],并获取肝组织标本,采用免疫组织化学法(SP)检测其肝脏组织中法尼醇受体(FXR)、胆盐输出泵(BSEP)、多耐药相关蛋白2(MRP2)的表达,并对上述指标进行相关性分析。结果两组TBIL对比差异无统计学意义(P>0.05),而研究组DBIL、TBA高于对照组,TC、TG低于对照组,差异均有统计学意义(P<0.05);研究组FXR、BSEP、MRP2水平[(2.15±0.34)、(4.21±0.51)、(4.35±0.56)均低于对照组,差异均有统计学意义(P<0.05);相关性分析显示,肝硬化并发胆囊结石患者FXR、BSEP、MRP2与血清TBA、DBIL呈负相关,且FXR表达水平与BSEP、MRP2均呈正相关(P<0.05)。结论胆汁酸代谢异常与肝硬化并发胆囊结石关系密切,其中FXR、BSEP、MRP2表达下调是其可能机制。
Objective To explore the relationship between bile acid metabolism and liver cirrhosis complicated with gallbladder stone.Methods 40 patients with liver cirrhosis complicated with gallbladder stone(the study group)and 36 cases of patients with simple gallbladder stone(the control group)admitted to our hospital from April 2015 to May 2017 were selected for the study.They were given the blood sampling at 1d before operation to detect the serum biochemical indexes[total bilirubin(TBIL),direct bilirubin(DBIL),total cholesterol(TC),triglyceride(TG),total bile acid(TBA)],and the liver tissue samples were obtained and the expression levels of farnesoid x receptor(FXR),bile salt export pump(BSEP)and multidrug resistance associated protein 2(MRP2)in liver tissues were detected by immunohistochemical method,and the above indexes were given the correlation analysis.Results There was no significant difference in the TBIL level between the two groups(P>0.05),and the levels of DBIL and TBA in the study group were higher than those in the control group while the levels of TC and TG were lower than those in the control group(P<0.05).The levels of FXR,BSEP and MRP2 with[(2.15±0.34),(4.21±0.51)and(4.35±0.56)points]in the study group were lower than those in the control group(P<0.05).Correlation analysis showed that the FXR,BSEP and MRP2 were negatively correlated with serum TBA and DBIL in patients with liver cirrhosis and gallbladder stone,and the expression level of FXR was positively correlated with BSEP and MRP2(P<0.05).Conclusion Bile acid metabolism abnormality is closely related to the liver cirrhosis complicated with gallbladder stone,and the down-regulation of FXR,BSEP and MRP2 expression is its possible mechanism.
作者
高聪
张宇
陈云飞
刘兵
GAO Cong;ZHANG Yu;CHEN Yunfei;LIU Bing(Emergency Surgery,Sichuan Provincial People's Hospital,Chengdu 610072,China;Hepatobiliary Surgery,Sichuan Provincial People s Hospital,Chengdu 610072,China)
出处
《西部医学》
2018年第11期1599-1602,1606,共5页
Medical Journal of West China
基金
四川省卫生厅科研课题(110243)
关键词
胆汁酸代谢异常
肝硬化
胆囊结石
关系
Bile acid metabolism abnormality
Liver cirrhosis
Gallbladder stone
Relationship
