急性病毒性肝炎患者胆囊排空功能研究

• 作 者: 陈仕珠 冯少华 邢保华 郭志刚
• 机 构: 解放军４５１医院内五科
• 出 处: 华人消化杂志
• 发表日期: 1998年03期
• 关键词: 急性病毒性肝炎 胆囊壁 病理生理学 实时超声 肝细胞损害 负相关 排出量 清胆 激素调控 肝实质损害

目的研究急性病毒性肝炎（ＡＶＨ）患者胆囊（ＧＢ）排空功能及其与病情程度和转归的关系．方法用实时超声研究了３２例ＡＶＨ患者及２６例健康对照者ＧＢ排空功能．结果空腹ＧＢ容量（ＦＧＶ）ＡＶＨ患者（１０２２±２３１）明显小于对照组（１９７９±１５１）（Ｐ＜０００１），随病程延长，ＦＧＶ渐增多．ＦＧＶ减少与病情程度呈显著负相关（Ｐ＜００５）．餐后ＧＢ排出量（ＧＥＦ）ＡＶＨ组显著少于对照组（Ｐ＜０００１），其减少与病情程度呈明显负相关（Ｐ＜００１），与血清胆红质、ＡＬＴ水平呈显著负相关（Ｐ＜００５～００１）．６０ｍｉｎ最大ＧＥＦ及ＧＢ排空速度明显减少、减慢（Ｐ＜０００１）．恢复期ＦＧＶ及餐后ＧＥＦ均恢复正常．结论ＡＶＨ患者存在ＦＧＶ和餐后ＧＥＦ异常．其机制与肝细胞损害，泌胆功能障碍及神经—激素调控失调有关．

Objective To investigate the role of gallbladder (GB) emptying in patients with acute viral hepatitis (AVH) and its relationship with the severity and outcome of gallbladder disease (GB). Methods The real-time ultrasound was used to study the GB evacuation function in 32 patients with AVH and 26 healthy controls. Results The fasting GBV (FGV) of AVH patients (1022 ± 231) was significantly lower than that of the control group (1979 ± 151) (P <0001). There was a significant negative correlation between the reduction of FGV and the severity of illness (P <005). The postprandial GB (GEF) output in AVH group was significantly lower than that in control group (P <0001), and the decrease was negatively correlated with the severity of illness (P <001), but significantly correlated with serum bilirubin and ALT Negative correlation (P <005 ~ 001). 60min maximum GEF and GB evacuation rate significantly reduced, slowed down (P <0  001). Recovery of FGV and postprandial GEF returned to normal. Conclusion AVH patients have FGV and postprandial GEF abnormalities. The mechanism of liver cell damage, biliary dysfunction and neuro-hormonal regulation disorders.