缩胆囊素在胆源性胰腺炎发病中的作用

目的探讨缩胆囊素(Cholecystokinin,CCK)在胆源性胰腺炎(Biliary pancreatitis,BP)发病中的作用及胆囊结石患者胰腺炎发病率高于肝胆管结石的原因。方法选用辽宁省人民医院2003-10-2004- 10收治的普外科住院患者及门诊体检中健康人群共163例(其中有30名正常体检者)为研究对象,既往无肝胆、胰腺病手术史,无梗阻性黄疸病史(包括本次入院)。将研究对象分为四组:正常对照组(30名)、胆囊结石组(78例)、肝胆管结石组(24例)、BP组(21例)。检测其血浆CCK浓度。结果BP组血浆CCK浓度明显高于正常对照组、肝胆管结石组及胆囊结石组(P<0．01),胆囊结石组血浆CCK浓度明显高于对照组及肝胆管结石组(P<0．01),正常对照组与肝胆管结石组对比无明显差异。以BP组为病例组,其余三组合为病例对照组。计算不同CCK浓度分组的相对危险度即比值比(OR值),结果BP病例组与病例对照组按不同的CCK浓度分组后,其组间有显著性差异,其OR值是随着CCK浓度的增加而递增,即随着CCK浓度的增加患胰腺炎的相对危险性也增加。结论胆囊结石患者血浆CCK浓度明显高于肝胆管结石患者,是胆囊结石患者胰腺炎的发病率较高的原因之一。CCK浓度与BP发病有密切关系,可能为BP病因之一。

Action of cholecystokinin in the pathogenesis of biliary pancreatitis

Objective To find out the action of cholecystokinin (CCK) in the palhogenesis of biliary pancreatitis and why pancreatitis incidence rate of gallbladder calculus is higher than that of hepatic-biliary duct calculus.Methods 163 cases without surgical operation history of liver,gall,pancreas and diabetes mellitus, as well as histories of other chronic depletion disease were selected from 10,2003 to 10,2004. The cases were divided into four groups: control group (30cases,all were normal persons), gallbladder calculus group(78cases),hepatic-biliary duct calculus group(24 cases),and BP group(31 cases). Results The CCK concentration in BP group was obviously higher than other groups (P<0.01),in gallbladder calculus group was obviously higher than in control group and hepatic-biliary duct calculus group (P<0.01); between control group and hepatic-biliary duct calculus group there had no obvious difference. The cases according to the ratings of CCK concentration were divided, and the relative risk ( OR value)of each levels were calculated.Between control group and case group there had statistics difference (P<0.01).Its OR value was of increase with the increment of CCK concentration,namely,the incidence rate of pancreatitis increase along with the increment of CCK concentration.Conclusion The plasma CCK concentration of gallbladder calculus group is obviously higher than hepatic-biliary duct calculus group maybe why the higher pancreatitis incidence rate in gallbladder calculus patient than that in hepatic-biliary duct calculus patients.Thus,CCK concentration is interpretablely correlated with the pathogenesis of BP,may be one of the etiological factor of BP.