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目的 探讨胆囊结石的胆固醇代谢变化。方法 采用高胆固醇膳食诱发兔胆囊结石模型 ,对进食高胆固醇膳食后 1,2 ,3,4周实验组和对照组血清脂蛋白胆固醇、肝脏总胆固醇 (HTC)、胆汁中胆固醇 (BC)和甘氨胆酸 (GCA) ,肝细胞低密度脂蛋白受体活性变化进行了动态研究。结果 高胆固醇膳食后 ,1周开始出现胆囊结石 ,2 ,3和 4周分别有 40 % ,6 0 % ,70 %出现胆囊结石。血清总胆固醇 (TC) ,甘油三酯 (TG ) ,磷脂 (PL) ,低密度脂蛋白胆固醇(LDL C)和极低密度脂蛋白胆固醇 (VLDL C) ,HTC ,BC均逐渐明显升高 (与对照组比较P均<0 .0 5 ) ;高密度脂蛋白胆固醇及其亚组分 (HDL C ,HDL2 C ,HDL3 C)有降低趋势 ,但无显著性差异 (P >0 .0 5 ) ;GCA逐渐降低 ,以 3周和 4周时明显 (P <0 .0 5 ) ;12 5I LDL与肝细胞低密度脂蛋白受体 (LDLr)最大结合力 (Bmax)在 1周组略升高 (P <0 .0 5 ) ,2周组逐渐下降 ,3周和 4周组时明显下降 (P <0 .0 5 ) ,解离常数Kd值逐渐升高 ,以 3周和 4周组明显 (P <0 .0 5 )。结论 随着高胆固醇膳食进食时间延长 ,血清及肝脏中胆固醇均增加 ,胆汁中胆固醇增加 ,肝细胞低密度脂蛋白受体活性下降 ,可能致胆汁中甘氨胆酸合成减少 ,成石性胆汁形成。提示胆固醇代谢中不同环节的变化均可在胆囊结石中
Objective To investigate the changes of cholesterol metabolism in gallstone. Methods Cholesterol induced cholecystolithiasis model was induced by high cholesterol diet. Serum lipoprotein cholesterol, total cholesterol (HTC), bile cholesterol (BC), and total cholesterol in experimental group and control group at 1, 2, Achondroic acid (GCA), hepatocyte LDL receptor activity were dynamically studied. The results of high cholesterol diet, gallbladder stones began to appear after 1 week, 2, 3 and 4 weeks were 40%, 60%, 70% gallstone. TC, TG, PL, LDL C, VLDL C, HTC and BC were significantly increased (with (P <0.05). The levels of HDL C, HDL2 C and HDL3 C in the control group were lower than those in the control group (P <0.05), but there was no significant difference between the two groups (P> 0.05). GCA decreased gradually (P <0.05) at 3 weeks and 4 weeks (P <0.05). The maximal binding force of 125I LDL to LDLr (Bmax) increased slightly in 1 week P <0.05). The levels in 2 weeks decreased gradually and decreased significantly in 3 weeks and 4 weeks (P <0. 05). The dissociation constant Kd increased gradually P <0. 05). Conclusions With the prolongation of hypercholesterolemia diet, the cholesterol in serum and liver are increased, the cholesterol in bile is increased and the activity of LDL receptor in hepatocytes is decreased, the synthesis of glycocholate in bile may be decreased and the formation of fossilized bile . Tip changes in different aspects of cholesterol metabolism can be in the gallbladder stones