| Objective:To study the effects of different oral drug regimens on serum biochemical indexes and bile components in cholecystolithiasis patients.Methods:Selecting 96 patients,based on the reports of hepatobiliary B ultrasound diagnosis,who wanted to undergo surgery to treat cholecystolithiasis from June 2019 to December 2019 in the outpatient department of the second affiliated hospital of Kunming Medical University.These patients judged to be feasible to undergo surgery were divided into group Ⅰ(preoperative administration of TUDCA)24 patients,group Ⅱ(preoperative administration of intestinal probiotics)24 patients,groupⅢ(preoperative combined administration of TUDCA and intestinal probiotics)24 patients and groupⅣ(blank control)24 patients.And biochemical tests on an empty stomach were demanded in all patients during the first outpatient visit.The patients in observation groups(group Ⅰ,ⅡandⅢ)underwent admission procedures to the waiting area for day operation,then completed the relevant auxiliary examinations and preoperative preparations,at the same time intaking TUDCA or/and intestinal probiotics 2 weeks according to the groups.After having completed preoperative examinations and excluded contraindications.the feasibilities of surgery were assessed by the surgeons and the risks by anesthesiologists,while biochemical tests were drawn before operations and bile were extracted during operations.The patients in the blank control group(groupⅣ)did not be intervened before operations.Having completed the relevant auxiliary examinations and preoperative preparations after admission,and excluded the contraindications of operations,bile were extracted during operations.Results:1.Subgroups analysis:patients who met the inclusion criteria were divided into group Ⅰ(preoperative administration of TUDCA),group Ⅱ(preoperative administration of intestinal probiotics),groupⅢ(preoperative combined administration of TUDCA and intestinal probiotics)and groupⅣ(blank control group)according to the randomized sequence table method.According to the comparison of sex,age and operation modes by different groups,the statistical results showed no significant difference(P>0.05),and it can be considered that the above indexes did not differ significantly in sex,age and operation modes.2.Results of serum biochemical tests:Total bile acids(TBA):Group Ⅰ before intervene 1.42±0.49μmol/L,after intervene 2.20±1.27μmol/L,the difference was statistically significant;Group Ⅱ before intervene 5.22±2.66μmol/L,after intervene 1.36±0.78μ/L,the difference was statistically significant;GroupⅢ before intervene 3.87±1.36μmol/L,after intervene 1.50±1.06μmol/L,the difference was statistically significant;GroupⅣ(no intervene)2.09±0.55μmol/L.Total cholesterol(TCHOL):Group Ⅰ before intervene 5.30±0.18mmol/L,after intervene 4.68±0.40mmol/L,the difference was statistically significant;Group Ⅱ before intervene 4.32±0.84mmol/L,after intervene 3.61±0.98mmol/L,the difference was statistically significant;GroupⅢ before intervene 4.67±1.19mmol/L,after intervene 3.99±1.06mmol/L,the difference was statistically significant;GroupⅣ(no intervene)3.94±0.87mmol/L.Triglycerides(TG):Group Ⅰ before intervene 2.33±0.60mmol/L,after intervene 1.43±0.57mmol/L,the difference was statistically significant;Group Ⅱbefore intervene 1.89±1.05mmol/L,after intervene 0.87±0.35mmol/L.the difference was statistically significant;GroupⅢ before intervene 1.54±0.72mmol/L,after intervene 1.14±0.51mmol/L,the difference was statistically significant;GroupⅣ(no intervene)1.33±0.7mmol/L.LDL cholesterol(LDL-C):Group Ⅰ before intervene 3.27±0.34mmol/L,after intervene 2.92±0.31mmnol/L,the difference was statistically significant;Group Ⅱ before intervene 2.48±0.48mmol/L,after intervene 2.09±0.68mmol/L,the difference was statistically significant;GroupⅢ before intervene 2.86±1.10mmol/L,after intervene 2.43±0.91 mmol/L,the difference was statistically significant;GroupⅣ(no intervene)2.43±0.75mmol/L.3.Results of total bile acids(TBA),phospholipids(PL)and cholesterol(TCHOL)in bile:Total bile acids(TBA):group Ⅱ 148.65±6.00mmol/L>group Ⅰ132.09±8.57mmol/L>groupⅢ 131.87±7.58mmol/L>groupⅣ 112.22±9.32mmol/L;Except the difference between group Ⅰ and groupⅢ was not statistically significant,the other differences were statistically significant.Phospholipid(PL):group Ⅱ15.43±2.48mmol/L<groupⅢ 23.52±4.24mmol/L<group Ⅰ24.35±4.82mmol/L<groupⅣ 34.79±4.45mmol/L;Except the difference between groupⅢ and group Ⅰ was not statistically significant,the other differences were statistically significant.Total cholesterol(TCHOL):Group Ⅱ9.81±1.46mmol/L<GroupⅢ 13.34±1.55<Group Ⅰ 14.18±2.57<groupⅣ19.28±2.74mmol/L;except the difference between groupⅢ and group Ⅰ was not statistically significant,the other differences were statistically significant.4.Test results of free Ca2+ concentration,pH value in bile:free Ca2+concentration:group Ⅱ 0.92±0.21mmol/L<group Ⅰ 1.51±0.36mmol/L<groupⅢ1.54±0.25mmol/L<groupⅣ 2.61±0.50mmol/L;the difference was statistically significant.pH value:group Ⅱ 6.90±0.25<groupⅢ 7.16±0.21<group Ⅰ7.43±0.25<groupⅣ 7.88±0.3 1;the differences were statistically significant.5.Detection of glycoprotein content in bile constituents:Glycoprotein content:Group Ⅱ 13.69±2.21μmol/L<GroupⅢ 19.21±2.93μmol/L<Group Ⅰ21.31±4.17μmol/L<groupⅣ 33.39±5.02μmnol/L;the differences were statistically significant.6.Test results of bile components cholic acid(CA),goose deoxycholic acid(CDCA),deoxycholic acid(DCA),cholic acid(LCA):CA:Group Ⅱ13.69±2.21ng/ml<groupⅢ 19.21±2.93ng/ml<group Ⅰ 21.31±4.17ng/ml<group 33.39±5.02;the differences were statistically significant.CDCA:Group Ⅱ3.60±1.05ng/ml<groupⅢ 6.98±2.11ng/ml<group Ⅰ 11.29±3.29ng/ml<groupⅣ1 7.93±4.47;the differences were statistically significant.DCA:Group Ⅱ3.29±1.16ng/ml<groupⅢ 6.49±2.06ng/ml<groupⅠ 11.41±3.41ng/ml<groupⅣ1 7.25±4.35;the differences were statistically significant.LCA:Group Ⅱ14.04±2.86ng/ml<groupⅢ 15.26±2.81ng/ml<groupⅣ 18.75±4.53<group Ⅰ20.66±4.43ng/ml;the differences between group Ⅱ&Ⅲ and groupⅣ&Ⅰ were not statistically significant,while the differences between any other two groups were statistically significant.Conclusions:TUDCA taken alone can lower TCHOL,TG and LDL-C in serum and increase TBA in serum;taking intestinal probiotics alone reduces TBA,TCHOL,TG and LDL-C in serum.However,combined use of TUDCA and intestinal probiotics does not enhance their individual role.In addition,taking intestinal probiotics alone can make the bile components of cholecystolithiasis develop in reverse direction towards stones formation,which is best compared with TUDCA alone as well as joint use of both. |
PDF Full Text Request