| Some ingredients of bile, such as cholochrome,cholesterol,mucin and calcium, separate out and agglutinate to stones under the influence of different sectors. Gradually, these stones would lead to cholelithiasis. Gallstone is the product of unusual biomineralization under pathological conditions, it is organic matrix (such as proteins, polysaccharides, etc.) at the molecular level to control mineral nucleation, growth and micro-assembly. According to the different chemical composition of stones, Cholelithiasis can be divided into cholesterol stones and bile pigment stones or mixed stones, thereinto cholesterol stones account for 90% or more. In the light of the differen part of stones formed,it can be divided into gallbladder stones, intrahepatic bile duct, extrahepatic bile duct stones, gallbladder stones account for 70% of cholesterol stones, while the primary bile duct stones is mainly the bile pigment stones , secondary common bile duct stones is from gallbladder cholesterol stones. Stones of different composition showed that the incidence of different mechanisms.At present,the reseach on bile acid of cholelithiasis, has mainly focused on the analysis of biological samples, such as plasma, urine and feces. The chemical ingredients'distribution of different biological samples can reflect different states of body physiology and pathology. Some research found that the ratio of chenodeoxycllolic acid(CDCA) in patients with cholesterol gallstone significantly decreased, while other analysis show the opposite result. When analysis bile acid of common duct stones and gallbladder stones in patients, People noticed that contents of taurolithocholic acid (TLCA) in bile acid are different on the analysis of common duct stones and gallbladder stones. The TLCA were increasing in patients with common bile duct stones, while reducing in gallbladder stone patients. Most of these studies is the detection of bile acids on plasma, but the bile is direct synthesis and secreted by the liver, Therefore, changes in chemical composition of bile are directly related to liver disease. Studies have shown that bile acids may be used as the degree of liver disease and liver toxicity index.The analysis of bile acids is particularly important for the diagnosis of hepatobiliary disease.Objective: Study the difference of the bile acid's types and contents on the cholelithiasis and non- cholelithiasis and cholelithiasis on the different parts. Meanwhile, I approach to the relationship between the abnormity of the bile acid's metabolization and the formation of gallstone.Methods: 48 cases of cholelithiasis were selected as experimental group, in which 33 patients aged 28 -87 years old with CBD stones, 16 male patient, 17 female patients; 15 cholelithiasis aged 29 -84 years old, 10 male patients, 5 female patients; 10 non- cholelithiasis aged 53 -86 years old in control group, 7 male patients, 3 female patients. Determine the type and content of sub-group of bile acids with the UPLC-MS.Results:1. The content of free bile acids CA, CDCA, DCA, LCA in the common bile dut stones, gallbladder stones and non- cholelithiasis was different, which has the statistical meaning, and from high to low, the content of free bile acids is: the common bile duct stone group> gallbladder stone group> non- cholelithiasis group.2. The LCA, DCA was contained in common bile duct stones and gallstone, rather than the free bile acids was not detected in non- cholelithiasis.3. Conjugated bile acids in bile samples of the three groups showed no significant difference.Conclusion:1.LCA, DCA may be characteristic markers of cholelithiasis;2. The ratio of CDCA in the CA/CDCA in the cholelithiasis group is declining compared to non- cholelithiasis.3. The different content of Free bile acids DCA, CA, CDCA content may be one for different reasons that the cholelithiasis's mechanism of formation in different part is different. |
PDF Full Text Request