肝外胆道动力学因素在胆囊结石形成中的作用

目的：探讨肝外胆道动力学因素在胆囊结石形成中的作用。方法：选用家兔４７只随机分为４组。对照组（ｎ＝１３），成石组（ｎ＝１４），消炎痛组（ｎ＝１０），红霉素组（ｎ＝１０）。饲养４周后检测成石情况、胆总管压力等指标。结果：成石组１２／１４只形成结石，消炎痛组４／１０只形成结石，红霉素组无一只形成结石。成石组胆汁中胆固醇和粘蛋白含量显著增高，胆囊管阻力和胆总管压力显著增高，胆囊排空率显著降低。消炎痛组较成石组胆汁中粘蛋白浓度降低，胆囊管阻力下降，胆总管压力下降，胆囊排空率无显著改善。红霉素组较成石组胆汁粘蛋白含量下降，胆囊管阻力下降，胆囊排空率增加而胆总管压力无显著变化。结论：除胆汁成分异常外，肝外胆道动力学因素参与了胆囊结石形成，改变肝外胆道动力学因素以促进胆囊排空，能有效地防止胆囊结石形成

The role of biliary dynamics factor outside the liver in gallstone formation

AIM:To determine the mechanism of biliary tract dynamics responsible for gallstone formation METHODS:Forty seven rabbits were divided into four groups,1)basical food in control,2) 1.2% cholesterol food in lithogenisis group (L),3)1.2% cholesterol food plus indomethacin in indomethacin group (1) and4) 1.2% cholesterol food plus erythromycin in erythromycin group (E).All animals were feed four weeks. RESULTS:12 out of 14 rabbits in group 2 developed gallstone, 4 out of 10 rabbits group 3 and 0 of 10 group 4 had gallstone formation. Group 2 showed much higher level of cholesterol and mucin in bile, much higher common bile duct pressure and cystic duct resistance, much lower gallbladder emptying ratet han those in control. Group 3 showed much lower mucin in bile, common bile duct pressure and cystic duct resistance, but no signifficant difference in gallbladder emptying rate compared with those group 2. Group 4 showed much lower mucin in bile, cystic duct resistance and much higher gallbladder emptying rate than those group 2. CONCLUSIONS:Besides abnormal bile components, biliary dynamics factor outside liver participate in gallstone formation. Gallbladder motility plays more important and direct role in lithogenisiss. It promoted gallbladder emptying by altering biliary dynamics out side liver,and can prevent gallstone formation effectively.