女性激素在胆囊胆固醇结石形成中的作用的研究现状

目的综述女性激素致胆囊胆固醇结石形成的机制,为预防雌、孕激素致石形成寻找途径。方法复习有关雌、孕激素致石形成的文献,总结其致石机制。结果雌激素主要通过核效应机制影响胆固醇代谢导致胆固醇结石形成,也可通过非核效应促使胆固醇成核及影响胆汁排空参与结石形成。孕激素通过核效应机制影响介导胆囊平滑肌收缩舒张的G蛋白α亚基损伤胆囊运动,通过非核效应途径影响离子通道及信号传导削弱胆囊运动,但孕酮的非核效应在结石形成中可能不起重要作用。结论女性激素致石机制复杂,明确其相关致石机制可为预防雌、孕激素致石形成开辟新途径。

Research Status of Female Hormone in Cholesterol Gallstones

Objective To review the mechanisms of cholesterol gallstones caused by female hormone so as to explore new treatments to prevent gallstones associated with estrogen and progesterone.MethodsThe literatures on gallstones related with female hormone were reviewed and the mechanisms of cholesterol gallstones were summarized.ResultsThe cholesterol gallstones mechanisms was affected by estrogen through genomic effects,and the nucleation of cholesterol was promoted by estrogen through nongenomic,which resulted in the formation of cholesterol gallstones.And the bile empty dysfunction associated with estrogen through nongenomic effects was also the reason of cholesterol gallstone formation.The G proteins α subunit responsible for the motility of gallbladder were disrupted by progesterone through genomic effects,and the ionic channels and signal transduction were also interfered through nongenomic pathway,which impaired the contraction of gallbladder.However,the nongenomic effects might not play an important role in the gallstones formation caused by progesterone.ConclusionsThe mechanisms of cholesterol gallstones formation associated with female hormone are complicated,the understanding of chelesterol gallstones formation mechanisms might be helpful to prevent gallstones associated with estrogen and progesterone.