| Objective: The incidence rate of liver cirrhosis patients with gallstones is higher than that of normal people,liver cirrhosis patients often have surgical contraindications which lead to treatment difficulties.Abnormal bile acid metabolism may be one of the main reasons to causes cholecystolithiasis in patients with liver cirrhosis,in which bile salt transporteres(BSEP,MRP2)play an important role.This experiment mainly research the differences of the BSEP,MRP2 and FXR expression in liver between the group of liver cirrhosis patients with gallstone and the group of simple cholecystolithiasis patients,combining with blood biochemistry to explore the role of bile acid metabolism abnormalities palyed in liver cirrhosis patients have got gallstone.Methods:1 Liver cirrhosis associated with gallstones patients 10 cases,simply cholecystolithiasis patients 18 cases,all patients accord with the entering standards.Before surgery,all patients underwent hepatobiliary ultrasound clearly suffering from gallstones and the group of cirrhosis patients proof with postoperative pathology.All the patients were draw blood samples for measure the serum total bilirubin,direct bilirubin,cholesterol,triglyceride and total bile acid on the preoperative day.Liver tissue samples were obtained during surgery,preserved in formalin and paraffin sections were made in 24 hours.2 Paraffin embedded specimens were handled with immunohistochemical method(SP method): separately detect the expression of FXR,BSEP and MRP2 in liver,image acquisitive pictures and assessment score with M standard.3 Statistical analysis: t'-test,rank test and correlation analysis were used to analysis the different objects,SPSS16.0 was the analysis software.The probability(P)-value less than 0.05 were cansidered to be statistically significant.Result:1 The biochemical mensuration in serum : The blood total bilirubin level in hepatic cirrhosis patients with gallstonewas group compare with the simple gallstone group has no statistically significant(P>0.05).The blood total bilirubin level in hepatic cirrhosis patients with gallstone group was significantly higher than that in simple gallstone group,and the difference was statistically significant(P<0.05).The total cholesterol levels level in hepatic cirrhosis patients with gallstone group was significantly higher than that in simple gallstone group,and the difference was statistically significant(P<0.05).The triglyceride levels level in hepatic cirrhosis patients with gallstone group was significantly higher than that in simple gallstone group,and the difference was statistically significant(P<0.05).The total bile acid levels level of hepatic cirrhosis patients with gallstone group was significantly higher than that in simple gallstone group,and the difference was statistically significant(P<0.05);2 The HE staining observation show that partial liver cell edema,fatty degeneration and connective tissue hyperplasia,inflammatory cell infiltration are visible in the pathological tissue of hepatic cirrhosis associated with gallstone group.The immunohistochemical technique observation show that FXR,BSEP and MRP2 were mainly localized in the cytoplasm and cell membrane,nucleus also have a small amount of expression,The hepatic expression of FXR,BSEP,MRP2 in hepatic cirrhosis patients with gallstone group was significantly lower than that in simple gallstone group(P<0.05),all of the differences were statistically significant;3 The correlated statistics of liver FXR expression with BSEP,MRP2 in simply gallstone group: the correlation coefficient of liver BSEP and FXR expression was 0.519 in simple gallstone group,has statistically significant(P<0.05),indicated a moderate degree of positive statistical correlation between BSEP and FXR expression.The correlation coefficient of liver MRP2 and FXR expression was 0.026 in simple gallstone group,with no statistical significance(P>0.05),indicated no statistical correlation between the liver MRP2 and FXR expression in simple gallstone group;4 The correlated statistics of licer FXR expression with BSEP,MRP2 in hepatic cirrhosis associated with gallstone group: the correlation coefficient of liver BSEP and FXR expression was 0.772 in hepatic cirrhosis associated with gallstone group,has statistically significant(P<0.05),indicated a strong degree of positive statistical correlation between liver BSEP and FXR in hepatic cirrhosis associated with gallstone group.The correlation coefficient of liver MRP2 and FXR expression was 0.778 in hepatic cirrhosis associated with gallstone group,has statistically significant(P<0.05),indicated a strong degree of positive statistical correlation between liver MRP2 and FXR expression in hepatic cirrhosis associated with gallstone group.Conclusion:1 The patients with liver cirrhosis have the low FXR and BSEP expression in the liver tissue,they provoke the high bile acid level in serum.This is one of the reason for the liver cirrhosis patients with cholecystolithiasis.2 The patients with liver cirrhosis have the low FXR and MRP2 expression in the liver tissue,they provoke the high direct bilirubin level in serum. |
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