瘦素、胆囊收缩素、血脂与胆石类型关系探讨

目的探讨瘦素（leptin）、缩胆囊肽（CCK）、血脂、胆固醇与Gs和HS两类胆石病关系。方法比较检测339例胆囊结石（Gs），67例肝胆管结石（HS）病员，20例正常对照者血清leptin、CCK、胰岛素、肝功能、血脂、脂蛋白等，评价各检测指标间关系。结果GS组leptin、CCK、BMI、胆固醇、甘油三酯、白蛋白、GGT、APO-a显著高于HS组（P〈0．05）；GS组内leptin与CCK、BMI、胰岛素、转氨酶、胆红素、胆固醇呈正相关（P〈0．05）；HS组内leptin与CCK、BMI、胰岛素、转氨酶、胆红素呈正相关（P〈0．01），与白蛋白、APO-a呈负相关（P〈0．05）。结论Leptin参与调控脂质代谢，两类胆石Leptin、血脂等存在明显差别，从调控脂质代谢角度探讨Leptin在两类胆石中的作用可能对阐明胆石成因具有价值。

Relation of leptin, cholecystokinin and plasma lipid to gallstone and hepatolithiasis

Objective To investigate the difference in serum leptin levels between gallstone and hepatolithiasis and to evaluate the relationship between serum leptin, cholecystokinin, lipid and lipoprotein concentrations. Methods Serum leptin, cholecystokinin, insulin, lipid, lipoprotein concentrations and liver function were determined in 339 patients with gallstone (group GS) and 67 patients with hepatolithiasis (group HS) and 20 healthy controls (control group). The levels of these index were compared among different groups. In each group, Pearson correlation among these indexes was evaluated. Results There were significant differences in serum leptin, cholecystokinin, BMI, total cholesterol and triglycerides, APO-a, gamma-glutamyl transpeptidase, and albumin between group GS and group HS (P<0.05). The positive correlation between serum leptin and cholecystokinin, BMI, total cholesterol, bilirubin, aminotransferase and insulin were found in group GS.In group HS, there was positive correlation between serum leptin and cholecystokinin, BMI, bilirubin, aminotransferase and insulin (P<0. 01), but negative correlation were found between serum leptin and albumin or APOa (P<0. 05). Conclusions Leptin participates in modulating lipid metabolism. There are notable difference in serum leptin, plasma lipid, and so on between group GS and group HS. It is valuable to study the role of leptin in cholelith pathophysiological course.