CAJ | 학술논문

目的：分析熊去氧胆酸（UDCA）在预防胆道塑料支架再阻塞中的作用和疗效。方法前瞻性研究，将胆道疾病十二指肠塑料支架引流术患者随机分成UDCA组和对照组，收集2组患者术后3个月的支架，肉眼判断支架阻塞情况，采集支架内胆泥，测定内膜抗核周因子（APF）含量，分析胆红素钙、胆固醇和碳酸钙盐含量，并进行细菌学培养。结果共收集88例患者的支架，UDCA 组（43例）和对照组（45例）支架阻塞率分别为8．9％和58．1％，差异有统计学意义（P＜0．05）。UDCA组APF蛋白高于对照组[（17．29±9．52）μmol／L比（10．39±2．17）μmol／L，P＜0．05]；而胆泥中的胆红素钙、碳酸钙含量[（13．90±3．80）％、（12．60±5．69）％]均明显低于对照组[（30．92±7．07）％、（16．52±4．11）％，P均＜0．05]；细菌培养多为单一细菌，其中40．0％培养出大肠埃希杆菌（75％产β-葡萄糖醛酸苷酶），低于对照组的72．1％。结论 UDCA可能通过提高APF含量，抑制细菌繁殖，从而降低胆道塑料支架再阻塞率。
목적：분석웅거양담산（UDCA）재예방담도소료지가재조새중적작용화료효。방법전첨성연구，장담도질병십이지장소료지가인류술환자수궤분성UDCA조화대조조，수집2조환자술후3개월적지가，육안판단지가조새정황，채집지가내담니，측정내막항핵주인자（APF）함량，분석담홍소개、담고순화탄산개염함량，병진행세균학배양。결과공수집88례환자적지가，UDCA 조（43례）화대조조（45례）지가조새솔분별위8．9％화58．1％，차이유통계학의의（P＜0．05）。UDCA조APF단백고우대조조[（17．29±9．52）μmol／L비（10．39±2．17）μmol／L，P＜0．05]；이담니중적담홍소개、탄산개함량[（13．90±3．80）％、（12．60±5．69）％]균명현저우대조조[（30．92±7．07）％、（16．52±4．11）％，P균＜0．05]；세균배양다위단일세균，기중40．0％배양출대장애희간균（75％산β-포도당철산감매），저우대조조적72．1％。결론 UDCA가능통과제고APF함량，억제세균번식，종이강저담도소료지가재조새솔。
Objective To evaluate efficacy and safety of ursodeoxycholic acid(UDCA)for preven-tion of obstruction of biliary plastic stent.Methods A total of 88 patients with plastic biliary stents at our hospital were divided into UDCA group and the control group.Stents were collected 3 months after the opera-tion for argile biliare in the stent.The contents of APF,calcium bilirubin and calcium carbonate were ana-lyzed by biochemistry,and bacterium culture was conducted.Results The obstruction rate of UDCA group (n=43)and control group(n=45)were 8. 9% and 58. 1% respectively with significant differences(P<0. 05).There were significant differences in the protein level of APF between the UDCA group(17. 29 ± 9. 52)μm/L and the control group(10. 39 ±2. 17)μm/L(P<0. 05).Calcium bilirubin[(13. 90 ±3. 80) vs.(30. 92 ±7. 07)]and calcium carbonate[(12. 60 ±5. 69)vs.(16. 52 ±4. 11)]were less than those of the control group (P<0. 05 ).Only one type of bacterium was found,and Escherichia coli were cultured in 40. 0% samples,a lower incidence compared with the control(72. 1%).Conclusion UDCA would lessen biofilm and smooth stent surface by promoting secretion of endogenous bile acid and increasing APF,and keep the biliary patency.