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中华普通外科学文献(电子版)

中华普通外科学文献(电子版) ›› 2015, Vol. 09 ›› Issue (05) : 346 -350. doi: 10.3877/cma.j.issn.1674-0793.2015.05.005

所属专题： 文献；

论著

胆道口括约肌运动功能与豚鼠胆固醇结石形成关系的研究
高成生1, 秦成坤2, 耿文茂2, 崔现平2, 咸国哲2, 张振海2,†()   
  1. 1. 271100　山东省莱芜市第二人民医院普外科
    2. 250021　济南，山东大学附属省立医院肝胆胰外科
  • 收稿日期:2015-05-16 出版日期:2015-10-01
  • 通信作者: 张振海
  • 基金资助:
    山东省自然基金资助项目(ZR2012HM079)

Role of Oddi sphincter motility in the process of cholesterol gallbladder stone formation in guinea pigs

Chengsheng Gao1, Chengkun Qin2, Wenmao Geng2, Xianping Cui2, Guozhe Xian2, Zhenhai Zhang2,†()   

  1. 1. Department of General Surgery, Laicheng District People’s Hospital of Shandong Province, Laiwu 271100, China
    2. Department of Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China
  • Received:2015-05-16 Published:2015-10-01
  • Corresponding author: Zhenhai Zhang
  • About author:
    Corresponding author: Zhang Zhenhai, Email:
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高成生, 秦成坤, 耿文茂, 崔现平, 咸国哲, 张振海. 胆道口括约肌运动功能与豚鼠胆固醇结石形成关系的研究[J]. 中华普通外科学文献(电子版), 2015, 09(05): 346-350.

Chengsheng Gao, Chengkun Qin, Wenmao Geng, Xianping Cui, Guozhe Xian, Zhenhai Zhang. Role of Oddi sphincter motility in the process of cholesterol gallbladder stone formation in guinea pigs[J]. Chinese Archives of General Surgery(Electronic Edition), 2015, 09(05): 346-350.

目的

研究胆道口(Oddi)括约肌运动功能在豚鼠胆囊胆固醇结石形成过程中的作用。

方法

34只成年雄性Hartley豚鼠随机分为胆固醇结石组(24只)和对照组(10只),其中胆固醇结石组(按被处死的时间,分为4个亚组,各6只)给予致石饮食,3、6、9、12周后对两组行胆道口括约肌测压并检测肌电活动。

结果

胆固醇结石组3、6、9、12周的发生率分别为0、16.7%、16.7%、83.3%。肌电活动的频率在3周组和6周组减小(均P < 0.05),肌电活动幅度在9周组和12周组明显降低[从(146.44 ± 81.09) μV分别降至(68.18 ± 49.58) μV和(40.60 ±45.03) μV, P <0.05]。胆道口括约肌收缩频率在6周组和9周组明显减小(P < 0.05)。胆道口括约肌基础压及胆总管压在12周组明显升高[从(25.19 ± 7.77) mmHg至(52.38 ± 12.84) mmHg,(22.35 ± 7.60) mmHg至(50.11 ± 12.59) mmHg,均P < 0.01]。

结论

致胆固醇结石饮食能诱发胆道口括约肌功能紊乱,其张力增加、活动性下降。胆道口括约肌运动功能紊乱是胆色素结石形成的一个重要因素。

关键词: 胆固醇结石, 胆道口括约肌, 测压, 肌电活动, 豚鼠
Objective

To investigate the role of Oddi sphincter motility in cholesterol gallbladder stone formation in model of guinea pigs.

Methods

Thirty-four adult male Hartley guinea pigs were divided randomly into two groups, control group (10 guinea pigs) and cholesterol stone groups (divided into 4 subgroups with 6 guinea pigs in each according to time they were sacrificed). The animals in cholesterol stone groups were fed with cholesterol lithogenic diet and sacrificed after 3, 6, 9 and 12 weeks. Sphincter of Oddi manometry and recording of myoelectric activity of the guinea pigs were obtained by multifunctional physiograph at each stage.

Results

The incidence of cholesterol gallstone formation was 0, 16.7%, 16.7% and 83.3% in 3 w, 6 w, 9 w and 12 w group. The frequency of myoelectric activity decreased apparently in the 3 w group and 6 w group (P<0.05). The amplitude of myoelectric activity decreased apparently, from (146.44±81.09) μV to (68.18±49.58) μV and (40.60±45.03) μV in the 9 w group and the 12 w group (P<0.05). The frequency of Oddi sphincter decreased apparently in the 6 w and 9 w group (P<0.05). The Oddi sphincter basal pressure and common bile duct pressure increased apparently in the 12 w group, from (25.19±7.77) mmHg to (52.38±12.84) mmHg and from (22.35±7.60) mmHg to (50.11±12.59) mmHg, respectively (P<0.01).

Conclusions

Cholesterol gallstone-causing diet can induce dysfunction of Oddi sphincter, the tension increased and its activity decreased. The disturbance of Oddi sphincter motility plays an important role in cholesterol gallstone formation.

Key words: Cholesterol gallstone, Oddi sphincter, Manometry, Myoelectric activity, Guinea pig
图1 对照组的肌电活动
图2 12周组的肌电活动
表1 胆结石形成过程中胆道口括约肌的肌电活动变化( ± s, t检验)
组别 n 振幅 频率
对照组 10 146.44±81.09 15.86±4.35
3周组 6 100.27±50.42 10.89±2.65
6周组 6 152.96±81.05 8.68±2.35
9周组 6 68.18±49.58 13.70±2.88
12周组 6 40.60±45.03 13.80±3.79
t1, t2,t3,t4值 ? 1.248, -0.156, 1.850, 2.913 2.513, 3.698, 1.075, 0.959
P1,P2,P3,P4值 ? >0.05, >0.05, <0.05, <0.05 <0.05, 0.05, >0.05
图3 对照组胆道口括约肌测压
图4 12周组胆道口括约肌测压
表2 在胆结石形成过程中的胆道口括约肌测压结果( ± s, t检验)
组别 n 括约肌基础压力 胆总管压力 括约肌幅度 括约肌频率
对照组 10 25.19±7.77 22.35±7.60 8.52±2.27 11.57±2.94
3周组 6 21.25±5.38 18.48±4.94 8.33±3.85 11.50±1.64
6周组 6 27.57±8.67 25.82±8.26 5.26±2.40 7.67±3.44
9周组 6 34.11±11.56 32.15±11.64 5.89±1.41 7.33±3.27
12周组 6 52.38±12.84 50.11±12.59 5.11±2.59 6.60±3.51
t1, t2,t3,t4值 ? 1.088, -0.569, -1.857, -5.327 1.117, -0.857, -2.052, -5.552 0.125, 2.724, 2.539, 2.764 0.053, 2.415, 2.682, 3.050
P1,P2,P3,P4值 ? >0.05,>0.05, >0.05, <0.01 >0.05,>0.05,<0.05, <0.01 >0.05, <0.05,<0.05, <0.05 >0.05, <0.05,<0.05, <0.05
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