胃动素和血管活性肠肽在不同部位及性质胆石症患者改变的临床研究

目的观察不同部位及性质胆石症患者胃动素(motilin,MTL)和血管活性肠肽(vasoactive intestinal peptide,VIP)含量变化,并探讨肠屏障功能在胆石形成中的作用和意义。方法选取2011年3月-2013年3月就诊于三六三医院且需进行手术治疗的胆结石患者108例,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,n=20)、胆囊结石组(B1组,n=36)、胆管结石组(C1组,n=36)、胆囊结石合并胆管结石组(D1组,n=36);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,n=20)、胆固醇结石组(B2组,n=40)、胆色素结石组(C2组,n=52)、混合性结石组(D2组,n=16)。分别采用放射免疫分析法测定各组血浆及回肠末端黏膜组织中MTL和VIP的含量。结果不同部位结石患者血浆及肠黏膜组织MTL和VIP的含量变化:B1、C1、D1组与A1组比较差异有统计学意义(P0.05),B1组与C1组比较,C1组与D1组比较,D1组与B1组比较,差异均无统计学意义(P0.05);不同性质结石患者血浆及肠黏膜组织MTL和VIP含量变化B2、C2、D2分别与A2组比较,差异有统计学意义(P0.05),C2组分别与B2、D2组比较差异有统计学意义(P0.05),B2组与D2组比较差异无统计学意义(P0.05)。结论胆色素结石患者存在血浆及肠黏膜组织MTL和VIP含量的改变,胆色素结石形成与肠屏障功能损伤一定的相关性,肠屏障功能损伤可能在促进胆色素结石的形成中发挥一定的作用。

Clinical research on the changes of motilin and vasoactive intestinal peptide in gallstones with different distributions and properties

Objective To observe the changes of motilin （MTL） and vasoactive intestinal peptide （VIP） in gallstone with different distributions and properties and investigate the role of intestinal barrier function in gallstone formation.Methods One hurdred and eight patients with gallstones who should be operated in 363 Hospital from Mar.2011 to Mar.2013 were chosen,and there were 20 healthy controls.According to different distributions of gallstones,patients were divided into the normol control group （A1 group,n =20）,the gallbladder group （B1 group,n =36）,the bile duct group （C1 group,n =36）,and the combined group which were gallbladders complicated with bile ducts （D1 group,n=36）.After operation,gallstones were collected to analyzed by chemical process.On the basis of different properties of gallstones,the normol control group （A2 group,n =20）,the cholesterol stone group （B2 group,n =40）,the pigment stone group （C2 group,n =52）,and the combination calculus group which were cholesterol stones complicated with pigment stones （D2 group,n =16） were chosen.MLT and VIP in blood and ileum mucosa were measured by radioimmunoassay.Results MLT and VIP both in blood and intestine showed higher levels in A1 group compared with B1,C1,D1 group （P ＜0.05）,but there was no significantly difference between B1 group and C1 group,as well as between C1 group and D1 group （P ＞0.05）.There were significant difference in A2 group compared with B2,C2,D2 group （P ＜ 0.05）,respectively.There were significant difference in C2 group compaced with B2,D2 group （P ＜ 0.05）,respectively.There was no signifcant difference between B2 group and D2 group （P ＞ 0.05）.Conclusion The changes of gastrointestinal endocrine hormone can be found in pigment stones.There may be a correlation between pigment stone formation and the damage of intestinal mucosal barrier function.It is possible that this kind of intestinal injury play a role in the pigment stone formation.