CAJ | 학술논문

目的观察不同部位及性质胆石症患者肠黏膜上皮细胞增殖及凋亡的改变，并探讨肠屏障功能在胆石形成中的作用和意义。方法按结石部位不同将108例胆石症患者分为三组：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），另设健康对照组（A1组，n ＝20）；根据结石不同性质分为胆固醇结石（B2组，n＝40），胆色素结石（C2组，n＝52），混合性结石组（D2组，n＝16），另设健康对照组（A2组，n＝20）；分别检测回肠末段黏膜组织学改变及肠黏膜上皮细胞增殖与凋亡率，并对检测结果进行对比分析。结果①不同部位结石患者A1、B1、C1、D1四组之间肠黏膜损伤程度、细胞凋亡与增殖率相比较均无显著性差异（ P ＞0．05）；②不同性质结石患者之间肠黏膜损伤程度、细胞凋亡与增殖率比较，C2组与B2组及A2组比较有统计学意义（均 P ＜0．05），与D2组比较，差异没有统计学意义（ P ＞0．05）。结论：胆色素结石患者均存在肠黏膜肠黏膜形态的损伤、细胞增殖下降和细胞凋亡增加的改变，胆色素结石形成与肠屏障功能损伤一定的相关性。肠黏膜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。
목적관찰불동부위급성질담석증환자장점막상피세포증식급조망적개변，병탐토장병장공능재담석형성중적작용화의의。방법안결석부위불동장108례담석증환자분위삼조：담낭결석조（B1조，n＝36），담관결석조（C1조，n ＝36），담낭결석합병담관결석조（D1조，n ＝36），령설건강대조조（A1조，n ＝20）；근거결석불동성질분위담고순결석（B2조，n＝40），담색소결석（C2조，n＝52），혼합성결석조（D2조，n＝16），령설건강대조조（A2조，n＝20）；분별검측회장말단점막조직학개변급장점막상피세포증식여조망솔，병대검측결과진행대비분석。결과①불동부위결석환자A1、B1、C1、D1사조지간장점막손상정도、세포조망여증식솔상비교균무현저성차이（ P ＞0．05）；②불동성질결석환자지간장점막손상정도、세포조망여증식솔비교，C2조여B2조급A2조비교유통계학의의（균 P ＜0．05），여D2조비교，차이몰유통계학의의（ P ＞0．05）。결론：담색소결석환자균존재장점막장점막형태적손상、세포증식하강화세포조망증가적개변，담색소결석형성여장병장공능손상일정적상관성。장점막병장공능손상가능재촉진담색소결석적형성중발휘일정적작용。
[Objective] To explore the changes of epithelial cell proliferation and apoptosis in gallstones with different distributions and properties and investigate the role of intestinal barrier function in gallstone for‐mation .[Methods]According to different distributions of gallstones ,there were normal control group (A1 ,n=20) ,gallbladder group (B1 ,n=36) ,bile duct group (C1 ,n=36) and combined group of gallbladders com‐plicated with bile duct (D1 ,n=36) .Also on the basis of different properties of gallstones ,there were normal control group (A2 ,n=20) ,cholesterol stone group (B2 ,n = 40) ,pigment stone group (C2 ,n =52) and combination calculus group of cholesterol stone complicated with pigment stone (D2 ,n =16) .The histology changes of terminal ileum mucosa and the rate of proliferation and apoptosis in intestinal mucosa cells were measured and analyzed .[Results] According to different distributions of gallstones ,no significant difference existed in pathohistology of intestinal mucosa injury and rate of proliferation and apoptosis among A1 ,B1 ,C1 and D1 groups .While with different properties of gallstones ,pathohistology of intestinal mucosa injury and rate of proliferation and apoptosis showed higher levels in C2 group versus B2 and A2 groups ( P≤0 .05) .But no difference existed between C2 and D2 groups ( P > 0 .05) .[Conclusion] Pigment stone has the grading changes of intestinal mucosa injury in pathohistology and proliferation and apoptosis in intestinal mucosa cells . And a probable correlation exists between pigment stone formation and damaged function of intestinal mucosal barrier .It is possible that this kind of intestinal injury play some roles in the pigment stone formation .