不同部位及性质胆石症患者肠黏膜通透性改变的临床分析

白顺滟; 肖思洁; 魏娜

doi:10.3969/j.issn.1001-5256.2014.06.017

不同部位及性质胆石症患者肠黏膜通透性改变的临床分析

DOI: 10.3969/j.issn.1001-5256.2014.06.017

成都三六三医院消化内科

基金项目:

四川省科技厅应用基础计划项目(2009JY0049)；

详细信息

中图分类号: R657.42
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出版历程
- 收稿日期: 2013-12-03
- 出版日期: 2014-06-20

Clinical study of changes in intestinal permeability in patients with gallstones of different distribution and properties

Department of Gastroenterology, 363 Hospital

Research funding:

摘要

摘要: 目的研究不同部位及性质胆石症患者肠黏膜通透性的改变,并探讨肠屏障功能在胆石形成中的作用。方法选择2011年3月-2013年3月收治的108例胆结石患者,健康对照者20例,按结石部位不同分为4组:健康对照组（A1组）、胆囊结石组（B1组）、胆管结石组（C1组）、胆囊结石合并胆管结石组（D1组）;所有入选患者全部行手术治疗,收集胆石进行化学分析,根据结石不同性质分为健康对照组（A2组）、胆固醇结石（B2组）、胆色素结石（C2组）、混合性结石组（D2组）。分别用分光光度法测定各组血浆及回肠末端黏膜组织中D-乳酸浓度、二胺氧化酶（DAO）活性,组间比较采用方差分析和LSD-t检验。结果（1）不同部位结石患者（A1、B1、C1、D1 4组）之间血浆及肠黏膜组织D-乳酸及DAO活性水平相比较差异无统计学意义（P>0.05）;（2）术后对胆石进行化学分析,胆固醇结石40例（37.04%）、胆色素结石52例（48.15%）,混合性结石16例（14.81%）;与A2组及B2组比较,C2组血浆及肠黏膜组织D-乳酸及DAO活性差异有统计学意义（P<0.05）,与D2组比较,差异无统计学意义（P...
- 胆结石 /
- 肠黏膜 /
- 通透性
Abstract: Objective To study the changes in intestinal permeability in patients with gallstones of different distribution and properties and to investigate the role of intestinal barrier function in gallstone formation. Methods A total of 108 patients with gallstones in our hospital in need of operation from March 2011 to March 2013 were enrolled in this study. Twenty healthy controls were also included. According to the distribution of gallstones, the subjects were separated into the following four groups: normal control group ( group A1) , gallbladder stone group ( group B1) , bile duct stone group ( group C1) , and combined group ( group D1) , in which gallbladder stones were complicated by bile duct stones. All patients underwent operation, and gallstones were collected for chemical analysis. According to the chemical properties of gallstones, the subjects were re-grouped as follows: normal control group ( group A2) , cholesterol stone group ( group B2) , pigment stone group ( group C2) , and mixed stone group ( group D2) , in which cholesterol stones were mixed with pigment stones. D- lactic acid level and diamine oxidase ( DAO) activity in plasma and mucosal tissue of the terminal ileum were measured by spectrophotometry. Differences were analysed by ANOVA and LSD t- test. Results Plasma D- lactic acid level and intestinal DAO activity showed no significant differences between groups A1, B1, C1, and D1 ( P > 0. 05) .Chemical analysis after surgery found 40 cases of cholesterol stones ( 37. 04%) , 52 cases of pigment stones ( 48. 15%) , and 16 cases of mixed stones ( 14. 8%) . Group C2 showed significantly different D- lactic acid level and DAO activity compared with B2 and A2 ( P < 0. 05) , but no differences from D2 ( P >0. 05) . Group B2 was found of no differences from A2 and D2 ( P >0. 05) . Conclusion Patients with pigment stones were all found of changes in intestinal permeability. The formation of pigment stones is related to impairment of intestinal barrier function. It is possible that impairment of intestinal barrier function plays a certain role in pigment stone formation.
- cholelithiasis /
- intestinal mucosa /
- permeability

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参考文献(9)

[1]SUN L, SU Y, WU SD.Observation of bacteria translocation and intestinal mucosa injury in pigment gallstone model in guinea pig[J].Chin J Microecol, 2009, 21 (8) :724-726. (in Chinese) 孙磊, 苏洋, 吴硕东.肠黏膜损伤和细菌易位对豚鼠胆色素结石形成的影响[J].中国微生态学杂志, 2009, 21 (8) :724-726.

[2]BRANDT LJ, BOLEY SJ.AGA technical review on intestinal ischemia.American Gastrointestinal Association[J].Gastroenterology, 2000, 118 (5) :954-968.

[3]CHEN YF, WU ZJ.Pathogenesis and risk factors of cholesterol gallstones in patients with non-alcoholic fatty liver disease[J].J Clin Hepatol, 2013, 29 (12) :952-955. (in Chinese) 陈永芳, 吴战军.非酒精性脂肪性肝病患者并发胆固醇性胆结石的发病机制及危险因素[J].临床肝胆病杂志, 2013, 29 (12) :952-955.

[4]LIU JH, WANG M, ZOU Y.Metagenomic analysis reveals gallstone types associated with gut microbiome community composition[J].J Clin Hepatol, 2012, 28 (7) :522-524. (in Chinese) 刘晶华, 王敏, 邹玉.常见三种类型胆结石胆汁中细菌群落的检测[J].临床肝胆病杂志, 2012, 28 (7) :522-524.

[5]LEI FM, CUI SH, ZHOU ZX, et al.Intestinal permeability after cholecystectomy or endoscopic mini-invasive cholecystolithotomy:a prospective control study[J].Chin J Endoscopy, 2012, 18 (4) :341-345. (in Chinese) 雷福明, 崔士华, 周振兴, 等.内镜下微创保胆手术和胆囊切除术对肠道通透性的影响:一项前瞻性对照研究[J].中国内镜杂志, 2012, 18 (4) :341-345.

[6]SUN SL, WU SD, SUI DM, et al.Determination of intestinal permeability in cholelithiasis patients by oral administration of technetium-99m-diethylenetriaminepentaacetatic acid[J].Natl Med J China, 2007, 87 (7) :464-467. (in Chinese) 孙韶龙, 吴硕东, 隋东明, 等.口服99Tmc-DTPA检测胆石症患者肠黏膜通透性[J].中华医学杂志, 2007, 87 (7) :464-467.

[7]SU Y, WU SD, FAN Y, et al.The preliminary experimental and clinical study of the relationship between the pigment gallstone and intestinal mucosal barrier[J].Gastroenterol Hepatol, 2009, 24 (8) :1451-1456.

[8]FAN Y, WU SD, SUN L, et al.Possible relationship between intestinal barrier function and formation of pigment gallstones in hamsters[J].Hepatobiliary Pancreat Dis Int, 2008, 7 (5) :529-532.

[9]WU SD, SU Y, FAN Y, et al.Relationship between pigment gallstone and intestinal barrier function:experiment with guinea pigs and clinical observations[J].Natl Med J China, 2008, 88 (21) :1498-1502. (in Chinese) 吴硕东, 苏洋, 范莹, 等.胆色素结石与肠屏障关系的动物实验及临床观察[J].中华医学杂志, 2008, 88 (21) :1498-1502.

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