| Objective: To study the change of gallbladder motility and its relationship to cholecystokinin(CCK) and nitric oxide(NO) by the comparison the level of plasma CCK and serum, tissue NO in patients with gallstones. It's slight to investigate the relationship between gallbladder motility and plasma CCK and NO level and to demonstrate its effect on pathogenesis of gallstone.Methods: 40 patients with gallstone (15 men and 25 women) average age 45 years and sex age-matched gallbladder polyp subjects (7 men and 13 women) were included in the present study. Based on the criterion of gallbladder average residual fraction plus 2 standard difference of the control group (RF+2SD), 40 gallstone patients were divided into two subgroups, contractor (n=16) and noncontractor (n=24) groups. The diagnosis had been based on B-ultrasound and surgery. All subjects had no other diseases and did not take the medicine which could affect the gallbladder motility, such as sodium cholate, glyceryl trinitrate, erythromycin, somatostatin and cisapride promoting dynamic drugs. All subjects received fasting and postprandial (eat two oiled eggs) B-ultrasound examination to measure gallbladder long, width and height to calculate fasting volume (FV), residual volume (RV), emptying volume(EV), emptying ratio (E%) , remains fraction (RF%). Got 1 specimen (from gallbladder body and big enough ) when the patients had operations and it was washed clean and blotted to keep in –80℃ refrigerator to test tissue NO and NOS. Plasma CCK was evaluated by radioimmuniassay and serum NO was evaluated by enzymology. Results: 1. The plasma CCK level in control and gallstone groups were 12.87±3.67 pmol/L, 34.84±19.63 pmol/L and in contractor and noncontractor groups were 13.40±2.44 pmol/L, 50.64±7.77 pmol/L and significantly increased in gallstone group compared with control group and significantly increased in noncontractor group compared with other groups. 2. The level of serum NO in control, gallstone groups, contractor and noncontractor subgroups were 79.88±12.57μmol/L,134.54±34.92μmol/L, 100.42±13.58μmol/L,159.68±21.51μmol/L. The serum NO were significantly increased in gallstone group compared with control groups and there were significantly difference between contractor and noncontractor groups. 3. Tissue level of NO,NOS in control, gallstone groups, contractor and noncontractor subgroups were 0.22±0.03μmol/gprot,0.39±0.07μmol/gprot, 0.32±0.03μmol/gprot,0.44±0.04μmol/gprot; 113.99±30.27 u/mgprot, 174.88±40.99 u/mgprot, 143.43±30.65 u/mgprot,203.32±48.29 u/mgprot and significantly increased step by step in control, contractor and noncontractor groups. 4. Fasting gallbladder volume in control, gallstone group, contractor and noncontractor groups were 22.36±4.12 ml3,30.05±10.99 ml3, 32.22±7.51 ml3, 28.45±12.90 ml3 and significantly increased in gallstone group compared with control group and there were significantly difference in contractor and control groups and there were no differece in noncontractor and control groups. 5. Residual volume in control, gallstone group, contractor and noncontractor groups were 5.92±1.86 ml3, 11.81±8.02 ml3, 7.76±3.18 ml3,14.78±9.21 ml3 and there were significantly difference between gallstone group and two gallstone subgroups compared with control group. Emptying volume and emptying ratio in control, gallstone, contractor and noncontractor groups were 16.39±4.97 ml3, 18.24±8.34 ml3,25.45±6.42 ml3, 13.67±6.47 ml3; 71.32±11.32%, 60.70±18.17 %, 75.96±9.09%, 49.45±14.58%. There were no significantly difference in gallstone group compared with control in gallbladder emptying volume. There were significantly difference in contractor group compared with noncontractor group in gallbladder emptying ratio. 6. There were significantly positive correlation between the serum, tissue NO and tissue NOS (r=0.74 P<0.01, r=0.80 P<0.01). 7. There was significantly negative correlation between the serum NO, tissue NO and gallbladder motility (r=-0.77 P<0.01, r=-0.66 P<0.01). 8...
|
PDF Full Text Request